The disease that I am going to highlight is End Stage Renal Disease which is commonly referred to as ESRD. ESRD can be defined as, “the last stage of chronic kidney disease. When your kidneys fail, it means they have stopped working well enough for you to survive without dialysis or a kidney transplant” (AKF) In the United States there are an alarming number of people who currently suffer from ESRD or who will have ESRD as some point in their life. Some statistics that support that include, “1 in 3 American adults is currently at risk for developing kidney disease” and “26 million American adults have kidney disease — and most don’t know it” (NKF). Medical anthropology would provide a basis to look at all of the factors causing ESRD whether they are genetic, socioeconomic, dietary, or any other situation that could lead to the culmination of the disease.
When you study ESRD it is important to look at the biological factors and ecological factors that play a role in a patient. “The likelihood of developing chronic kidney disease in an individual is determined by interactions between genes and the environment” (NCBI). Many biological factors that are inherited through genes can lead a person to develop ESRD in their lifetime, such as hypertension and type-1 diabetes. However, there are many ways in which patient’s relationship with the environment can determine whether or not they will develop ESRD. Limited access to healthy food is contributing to a rise in populations affected by diabetes. It is then that kidney disease becomes a product of the environment without healthy food options. “More than 35% of all people age 20 or older with diabetes have kidney disease” (NKF).
An ethnomedical approach can be described as one that looks at the cultural beliefs that affect a society. This idea gives patients the option of choosing between many different ideas of medicine from biomedicine to traditional healers. ESRD is something that requires treatment in the form of dialysis or a transplant. In the United States there is a culture that relies heavily on biomedicine but at an extreme cost. “Annual medical payments for a patient with kidney disease increase from $15,000 in stage 3 to $28,000 in stage 4 to more than $70,000 in stage” (NKF).
An experiential approach to dealing with ESRD would be one that examines how the disease is experienced for each patient. In the United States the cost of suffering from ESRD is very high. This leads people who suffer from into dealing with a financial burden. Dialysis is a common treatment that leads to a lot of time spent on maintaining health. “Discussions by physicians about dialysis or transplantation often include information about the treatment itself but rarely consider how patients feel on dialysis, the differences between the dialysis treatments, or which of their usual activities they may be able to continue” (CJASN). By looking at how a patient is going to experience life after ESRD on dialysis or with a transplant is a vital part of the equation.
Taking an applied approach while looking at ESRD would allow focus to be placed on what the solution to ESRD would be. “Major risk factors for kidney disease include diabetes, high blood pressure, family history of kidney failure and being age 60 or older. Additional risk factors include kidney stones, smoking, obesity and cardiovascular disease” (NKF) The applied approach would be able to look at all the causes as a whole and figure out how to combat these problems before they begin. Trying and educate about a healthy diet to keep hypertension to a minimum or educate about smoking would be a good place to start for an applied approach to ESRD.
Finally, a critical anthropological approach would look at which treatments are proven effective. In regards to ESRD dialysis and transplantation are two methods that have worked. A critical anthropologist could use this information to make dialysis available to everyone as well as transplantation if a person chooses that is what they would like their treatment to be.
I think the most effective approach to ESRD is the biomedical approach. This approach is something I believe strongly in because biomedicine has helped me through over 2 years combined of dialysis and 2 transplants. The advancements in technology and in developing drugs have come so far and if we focus more energy on this approach we can have more successful stories just like mine.
“Fast Facts.” The National Kidney Foundation. N.p., 12 Aug. 2014. Web. 18 Aug. 2016.
Clinical Journal of the American Society of Nephrology, http://cjasn.asnjournals.org/content/4/12/2008.full
Genetic factors in end-stage renal disease. Pubmed.gov, NCBI