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Cocaine use and chronic renal failure.

Urban communities vary from suburban and rural communities in several ways, which are reflected in a modified risk for different causes of chronic renal disease. Many rural communities are more similar to urban communities in regard to socioeconomic adversities, access to health care, and other related challenges. It is important to recognize that high population density is commonly associated with a unique set of cultural practices including higher rates of perceived stress, recidivism and incarceration, and substance abuse. Each of these may predispose to higher rates of selected renal disorders such as hypertensive nephrosclerosis, human immunodeficiency virus (HIV) nephropathy, and substance abuse-associated renal disease. Having an understanding of urban culture and lifestyle can increase the awareness of potential contributing factors to chronic renal failure (CRF) in this population and assist in developing screening programs for high-risk individuals, considering specific diagnoses that may not be readily apparent and implementing effective early treatment.