Disadvantaged populations across the globe exhibit a disproportionate burden of chronic kidney disease (CKD) because of differences in CKD occurrence and outcomes. Although many CKD risk factors can be managed and modified to optimize clinical outcomes, the prevailing socioeconomic and cultural factors in disadvantaged populations, more often than not, militate against optimum clinical outcomes. In addition, disadvantaged populations exhibit a broader spectrum of CKD risk factors and may be genetically predisposed to an earlier onset and a more rapid progression of chronic kidney disease. A basic understanding of the vulnerabilities of the disadvantaged populations will facilitate the adaptation and adoption of the kidney disease treatment and prevention guidelines for these vulnerable populations. The purpose of this paper is to examine recent discoveries and data on CKD occurrence and outcomes in disadvantaged populations and explore strategies for the prevention and treatment of CKD in these populations based on the established guidelines. 1. Background and Epidemiology The global prevalence of chronic kidney disease (CKD) is increasing and creating enormous socioeconomic burdens for patients, families, society, and the health care system across the globe. Data from the third National Health and Nutrition Examination Survey (NHANES 1999–2004) suggest that about 1 out of 8 adult Americans exhibit evidence of CKD [1]. Comparable estimates have been reported in Asia [2], Australia [3], and across Europe [4–6]. The lack of national registries and limited representative national surveys in developing countries make the estimation of the burden of CKD in these countries difficult. However, the risk factors for CKD are known to be just as prevalent in many developing countries as in the developed countries. Therefore, the burden of CKD in those developing countries may be comparable to those of the developed countries. In addition, developing countries exhibit a disproportionate burden of infectious and environmental factors that broaden the spectrum of CKD risk factors and is apt to increase CKD burden. A greater understanding of CKD onset and progression among racial/ethnic minorities and socioeconomically disadvantaged persons in the US may provide insights into CKD burdens in similar populations globally. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines by the National Kidney Foundation in 2002 defined CKD as functional and structural abnormalities of the kidneys that persist for more than three months. This widely publicized and
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