Disparities in incidence of diabetic end-stage renal disease according to race and type of diabetes

Article Abstract:

End-stage renal disease is a severe deterioration of kidney function that renders the kidneys ineffective. Treatment of this severe pathologic symptom involves dialysis and kidney transplantation from cadavers. Severe diabetes mellitus all too frequently results in end-stage renal disease. Prior studies have established that significantly higher numbers of Afro-Americans suffer from diabetes than do whites. The epidemiologic and statistical relationship of both insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes mellitus was studied in a population of both black and white diabetics with end-stage renal disease. In a study of 1,331 such patients, approximately one third of whom were Afro-Americans, the rate for blacks was significantly higher than for whites: after adjustment for the increased prevalence of diabetes among blacks, an increased risk factor of 2.6-fold was seen for diabetic end-stage renal disease among blacks. Surprisingly, 72 percent of those blacks with end-stage renal disease had NIDDM versus 42 percent of whites. The overall risk of end-stage renal disease was found to be 5.8 percent for IDDM and only 0.5 percent for NIDDM. The overall risk for blacks with IDDM developing end-stage renal disease, when adjusted for other risk factors, is only approximately 60 percent greater than for white IDDM patients. The disparity between the races in the incidence of diabetic end-stage renal disease applies only to those individual who are younger than 65, the age past which most patients would have be expected to have NIDDM. This study demonstrates a highly significant racial difference in the occurrence of end-stage renal disease, particularly in NIDDM for black patients. Blacks are known to have a higher rate of hypertension (elevated blood pressure), which may be related. A preliminary study has also suggested that better control of both blood sugar and blood pressure may be beneficial and that the difference between the races may be preventable.

Research, Complications and side effects, Demographic aspects, African Americans, Diseases, Diabetes, Diabetes mellitus, Type 2 diabetes, Diabetic nephropathies, Caucasian race, Whites, Kidney diseases

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Chronic renal failure after transplantation of a nonrenal organ

Article Abstract:

Some organ transplant recipients may develop kidney failure within a few years after the transplant, which will increase their risk of premature death. In a study of 69,321 people who received an organ transplant over a 10-year period, between 7% and 21% developed kidney failure. The risk varied depending on what type of organ they received and these patients were four times more likely to die than organ transplant recipients who did not develop kidney failure.

Causes of, Organ transplant recipients, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Chronic kidney failure, Death of

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Effect of changing the priority for HLA matching on the rates and outcomes of kidney transplantation in minority groups

Article Abstract:

A study was conducted, using a Cox model for the time from placement on the waiting list to transplantation, to find out whether a change in allocation policy of kidney transplantation would affect the survival and the racial balance. The result from the study reveals the inherent conflict between the utility and equity of HLA-based allocation of kidneys for transplantation.

United States, Management dynamics, Management, Usage, Kidney transplantation, Minorities, HLA histocompatibility antigens, HLA antigens, Company business management, Discrimination in medical care, Medical care discrimination, Histocompatibility antigens

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