Race and diabetic nephropathy.
Blacks who are at a greater risk of renal failure than whites also experience a greater prevalence of diabetic nephropathy. Preliminary data suggest that black uremic diabetics fare less well than whites following a kidney transplant. Planning treatment for the diabetic with progressive renal insufficiency requires an allowance for the high probability that coincident multisystem disease will develop. We now understand that the mysterious concept of unmanageable "brittle diabetes" was a myth derived from flawed interaction between patient and physician. By establishing a team approach, the patient is protected from the stress of having conflicting treatment protocols prescribed by physicians concerned with only one organ or system. Black diabetics who may often have less family income than whites may require more intensive support from social workers and diabetes educators to understand and cope with the burden of kidney failure. The majority of uremic diabetics, both black and white, can survive at least the first 3 years of dialysis or renal transplantation with preserved sight and intact limbs. It may be anticipated that the proportion of nephropathic diabetics who attain rehabilitation will continue to increase.
D044383:Black People; D002318:Cardiovascular Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology; D048909:Diabetes Complications; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D005128:Eye Diseases / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000523:psychology; D016030:Kidney Transplantation; D011183:Postoperative Complications; D014481:United States; D001745:Urinary Bladder Diseases / Q000209:etiology; D001741:Black or African American