BLACKS HAVE HIGHER RISK OF END-STAGE RENAL DISEASE

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BLACKS HAVE HIGHER RISK OF END-STAGE RENAL DISEASE.

End-stage renal disease (ESRD) is more common among blacks than whites, and two new studies suggest that blacks may actually be more susceptible to this disorder.

The first study examined risk factors for diabetic ESRD by combining data from a regional ESRD registry and a hypertension survey in Maryland. After adjusting for age, diabetes prevalence, hypertension, access to health care, and college education, blacks had a relative risk of diabetic ESRD of 2.7, as compared with whites. This excess risk was confined to persons with non-insulin-dependent diabetes (relative risk among blacks, 4.8).

The second study evaluated the relation between blood pressure control and changes in renal function among 5524 men from the Multiple Risk Factor Intervention Trial (MRFIT) who had mild to moderate hypertension. Renal function was assessed by measuring serum creatinine over an average of 7 years. Decline in renal function was greater in older subjects, in persons with elevated systolic or diastolic blood pressure, and in blacks (after controlling for age and blood pressure). Effective blood pressure control was not associated with improved renal function in blacks, but it was in nonblacks.

These data suggest that blacks may be especially vulnerable to ESRD, even if they maintain excellent control of hypertension, and that blacks with Type II diabetes are at markedly greater risk for this syndrome.

— THL

Published in Journal Watch General Medicine December 8, 1992

Citation(s):

Walker WG et al. Renal function change in hypertensive members of the Multiple Risk Factor Intervention Trial: racial and treatment effects. JAMA 1992 Dec 2 268 3085-3091.

Medline abstract (Free)

Brancati FL et al. The excess incidence of diabetic end-stage renal disease among blacks: a population-based study of potential explanatory factors. JAMA 1992 Dec 2 268 3079-3084.