Why is there so much end-stage renal failure of undetermined cause in UK Indo-Asians?
There is a high incidence of end-stage renal failure (ESRF) of undetermined cause in the Indo-Asian population of the UK. We studied patients presenting from the district of Brent and Harrow, which has a large Indo-Asian community, and whose renal services are largely provided by our centre. The diagnosis and ethnicity of patients starting renal replacement therapy and/or undergoing renal biopsy were collated. The incidences of ESRF, rates of renal biopsy and underlying diagnoses were calculated for Indo-Asians and Caucasians. Requirement for renal replacement therapy in Indo-Asians presenting to our centre from Brent and Harrow was 221/10(6)/year; no underlying diagnosis was identified in 77/10(6)/year. Renal biopsy rate in these patients was 456/10(6)/year, and the diagnostic categories significantly over-represented compared to Caucasians were: hypertension and ischaemia, focal segmental glomerulosclerosis (FSGS), idiopathic interstitial nephritis (IIN), diabetic nephropathy, minor glomerular abnormality, lupus nephritis and non-specific advanced chronic renal disease (p<0.001). The first three of these had a combined incidence of 135/10(6)/year in Indo-Asians and 31/10(6)/year in Caucasians. ESRF of undetermined cause is common in UK Indo-Asians, as is requirement for renal biopsy. Hypertension with ischaemia, FSGS and IIN are over-represented in the Indo-Asian population, and should be targeted for early diagnosis and treatment in this group.
Ball
S
S
Renal Unit, Mint Wing, St Mary's Hospital, Praed Street, London W2 1NY, UK.
Lloyd
J
J
Cairns
T
T
Cook
T
T
Palmer
A
A
Cattell
V
V
Taube
D
D
D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D001706:Biopsy / Q000706:statistics & numerical data; D003928:Diabetic Nephropathies / Q000150:complications / Q000208:ethnology / Q000628:therapy; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000208:ethnology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000208:ethnology / Q000628:therapy; D015994:Incidence; D007194:India / Q000208:ethnology; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000150:complications / Q000208:ethnology / Q000628:therapy; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology