N
Engl J Med 1989 Oct 19;321(16):1074-9
Comment in:
N Engl J Med. 1989 Oct 19;321(16):1121-2.
Disparities in incidence of diabetic end-stage renal disease according
to race and type of diabetes.
Cowie CC, Port FK, Wolfe RA, Savage PJ, Moll PP, Hawthorne VM.
Social & Scientific Systems, Bethesda, Md 20814.
The incidence of end-stage renal disease in patients with diabetes mellitus
is reportedly higher among blacks than among whites. This finding may
be explained by the greater prevalence of diabetes among blacks. The relation
of the type of diabetes to the risk of diabetic end-stage renal disease
is largely unstudied. We addressed these issues in a study of all the
black and white diabetic patients with end-stage renal disease (470 blacks
and 861 whites) reported to the Michigan Kidney Registry who began treatment
during 1974 through 1983. We also reviewed the medical records of a subpopulation
of such patients (284 blacks and 310 whites) who were less than 65 years
of age at the start of treatment for end-stage renal disease to determine
what type of diabetes they had. In this study, we made use of national
data on the prevalence of diabetes. We found that the incidence of diabetic
end-stage renal disease was 2.6-fold higher (P less than or equal to 0.0001)
among blacks after we adjusted for the higher prevalence of diabetes among
blacks, with the excess risk occurring predominantly among blacks with
non-insulin-dependent diabetes mellitus (NIDDM). Most black patients with
diabetic end-stage renal disease had NIDDM (77 percent), whereas most
white patients with diabetic end-stage renal disease had insulin-dependent
diabetes mellitus (IDDM) (58 percent) (P less than or equal to 0.0005
for the difference between the races). For both races combined, the risk
of diabetic end-stage renal disease during the 10-year period we studied
was markedly greater for patients with IDDM (5.8 percent) than for those
with NIDDM (0.5 percent). Our results indicate an increased risk of diabetic
end-stage renal disease among blacks as compared with whites, particularly
blacks with NIDDM. Although the risk of diabetic end-stage renal disease
is higher in patients with IDDM, the majority of patients with diabetic
end-stage renal disease in the population we studied had NIDDM.
PMID: 2797067 [PubMed - indexed for MEDLINE]
N Engl J Med 1989 Oct 19;321(16):1121-2
Comment on:
N Engl J Med. 1989 Oct 19;321(16):1074-9.
Diabetic renal disease in blacks--inevitable or preventable?
Rostand SG.
Publication Types: Comment; Editorial
PMID: 2797070 [PubMed - indexed for MEDLINE]
