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Comparative Patterns in CKD among Native Israeli and Immigrant Ethnic Populations
Yael Einbinder1,2, Tzipi Hornik-Lurie3, Keren Cohen-Hagai1,2
1Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
Clinical Journal of the American Society of Nephrology : CJASN
|December 1, 2025
Summary
Chronic kidney disease (CKD) progression varies significantly among ethnic groups in Israel. Ethiopian immigrants showed faster CKD progression in younger individuals, while native Arabs faced the highest risk across all ages.
Area of Science:
- Nephrology and Public Health
- Epidemiology of Chronic Diseases
- Ethnic Disparities in Healthcare
Background:
- Chronic kidney disease (CKD) is a major global health concern, significantly impacting morbidity and mortality.
- Existing research indicates considerable variation in CKD prevalence and progression rates across diverse ethnic populations.
- Understanding these ethnic differences is crucial for targeted public health interventions and equitable healthcare delivery.
Purpose of the Study:
- To investigate and compare the prevalence and progression of chronic kidney disease (CKD) among distinct ethnic groups within Israel.
- To identify specific ethnic populations at higher risk for CKD development and adverse progression.
- To analyze the influence of demographic factors and traditional risk factors on CKD outcomes in different ethnic cohorts.
Main Methods:
- Retrospective longitudinal cohort study utilizing electronic medical records from Clalit Health Services, a large Israeli healthcare provider.
- Inclusion of over 1.6 million members, comprising Ethiopian immigrants, former Soviet Union immigrants, native-born Arabs, and native-born Jews.
- Assessment of CKD progression based on estimated glomerular filtration rate (eGFR) decline (≥50%), initiation of renal replacement therapy, or mortality.
Main Results:
- Ethiopian immigrants exhibited lower CKD prevalence but demonstrated faster CKD progression among individuals under 50 years old (HR 1.47).
- The native Arab population presented with higher BMI and diabetes prevalence, alongside the greatest risk for significant eGFR decline (HR 1.75) across all age groups.
- Young Ethiopian individuals showed increased risk and accelerated eGFR decline, independent of traditional risk factors, highlighting unique disease pathways.
Conclusions:
- Significant ethnic variations in CKD prevalence and progression exist within the Israeli population, necessitating tailored clinical and public health strategies.
- Native Arab populations face a disproportionately high risk of CKD progression, linked to higher rates of obesity and diabetes.
- Younger Ethiopian immigrants exhibit a distinct pattern of accelerated CKD progression, warranting further investigation into underlying mechanisms beyond traditional risk factors.
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