Gaining Community Trust Enables Research Designed to Reduce the National Burden of Chronic Kidney Disease

Chronic kidney disease (CKD) incidence, rate of progression toward end-stage kidney disease, and its adverse outcomes are greater in under-resourced, minoritized United States (US) communities where health-related social determinants contribute to their risk for incidence of and adverse outcomes from CKD and other chronic diseases. Research needed in these communities at high risk for CKD and other chronic diseases to develop better community-based management strategies is hindered by the justified historic mistrust these communities have for the US clinical and research enterprise. Insights and conclusions derived from initial community-based studies designed to examine the benefits to kidney health of healthy eating including added dietary fruits and vegetables, adjunctive to standard pharmacologic kidney-protective care. These studies required first to establish and then leverage collaboration with leadership of community institutions with already established community trust. The studies described herein successfully established and then leveraged trust of the leadership of local churches and other community-based institutions in under-resourced, minoritized communities. This then enabled recruitment and retention of study participants from these communities at high risk for CKD and other chronic diseases, with recruitment and follow up occurring at these institutions rather than in traditional academic settings. The studies showed enhanced kidney health with healthy eating adjunctive to standard pharmacologic kidney-protective care. These studies show the necessity of gaining community trust to facilitate studies done in under-resourced, minoritized communities at high risk for CKD and other chronic diseases. This trust was gained through collaborating with institutional community leadership that already had community trust. Future research to develop needed evidenced based strategies for CKD and other chronic diseases will require proactive outreach to establish trust that will enable collaborative and effective working relationships with community-based institutions.