Comparative Patterns in CKD among Native Israeli and Immigrant Ethnic Populations

CKD is a prevalent condition that contributes significantly to morbidity and mortality. The prevalence and progression of CKD vary across different ethnic groups. This study aimed to evaluate the prevalence and progression of CKD among various ethnic populations in the state of Israel including native Israelis and immigrant communities. This retrospective longitudinal cohort study included immigrants from Ethiopia and the former Soviet Union as well as native-born Arab and Jewish populations in Israel. Data were obtained from the electronic medical records of Clalit Health Services, the largest health care organization in Israel, serving over 4.7 million members. CKD progression was assessed based on eGFR derived from serum creatinine measurements, identifying cases with a ≥50% decline in eGFR, initiation of renal replacement therapy, or death during the study period. The cohort included 1,612,415 Clalit Health Services members, including 40,599 Ethiopian immigrants (mean age 45.6±15.9 years), 273,330 former Soviet Union immigrants (mean age 55.9±17.4 years), 399,965 Israeli-born Arab individuals (mean age 43.7±13.8 years), and 898,521 Israeli-born Jewish individuals (mean age 43.1±14.3 years). Ethiopian immigrants had a higher baseline eGFR, lower traditional risk factors, and lowest prevalence of CKD stages 3 and 4. However, CKD progression was faster among the younger subset of this group, <50 years, with hazard ratio of 1.47 (95% confidence interval, 1.30 to 1.66) for ≥50% decline in eGFR. The native Arab population had the highest body mass index and higher prevalence of diabetes and demonstrated the highest risk of ≥50% decline in eGFR (hazard ratio,1.75; 95% confidence interval, 1.72 to 1.78), consistent across all age groups. Young Ethiopian individuals demonstrated higher risk and faster decline in eGFR independent of traditional risk factors. The native Arab population had highest risk for CKD progression across all ages. Further studies focusing on both of these ethnic populations are urgently needed.