The Case for Anti-Racism Practice and Research in Nephrology Social Work: A Call to Action

Abstract

Racial inequities in kidney disease represent one of the most pressing challenges in healthcare, yet nephrology social work has not fully engaged anti-racist frameworks to address these disparities. Black Americans are four times more likely than white Americans to experience kidney failure and continue to face significant barriers to transplantation and survival. Other historically oppressed groups also bear a disproportionate burden of kidney disease, underscoring the need for systemic change. While the broader social work profession has embraced anti-racist commitments, nephrology social workers, who play critical roles in transplant referrals, psychosocial assessments, and patient advocacy, lack formal models to dismantle structural racism in kidney care. This paper argues that anti-racist nephrology social work must move beyond symbolic declarations toward structural transformation. Drawing on Public Health Critical Race Praxis, we propose an approach that emphasizes intersectional perspectives, nuanced analyses, and interventions aimed at changing systems rather than simply documenting disparities. Nephrology social workers are uniquely positioned to advance anti-racist practice across micro, mezzo, and macro levels of care, building on the profession’s longstanding commitment to advocacy and social justice. By centering patient voices and challenging institutional practices that reproduce inequity, nephrology social work can help reshape kidney care to more fully promote health equity.