Diabetic renal failure in Texas: influence of ethnicity and household income.
Although end-stage renal disease (ESRD) remains a major public health problem in Texas, information regarding the influence of ethnicity and socioeconomic status on the prevalence of ESRD in Texas counties is limited. To determine whether ethnicity and a surrogate marker of socioeconomic status influence the prevalence of dialysis-related ESRD and of diabetic nephropathy ESRD (ESRD-DM) in Texas, we calculated indirect prevalence rates for each county by using 1998 data on 19,336 patients in 80 counties. Using weighted multiple linear regression, we estimated ESRD and ESRD-DM ethnic prevalence. We estimated that among dialysis patients with ESRD, the indirect ethnic prevalence rate was highest for blacks, whereas when ESRD-DM was considered, Hispanics showed the highest prevalence, followed by blacks and then by non-Hispanic non-blacks. When the socioeconomic factor was incorporated into the regression model, the ESRD ethnic prevalence was highest for blacks living in poor counties and for Hispanics living in wealthy counties; however, for ESRD-DM, the ethnic prevalence rate was highest for Hispanics, whether they lived in poor or wealthy counties. Ethnicity and socioeconomic status accounted for 94% (93%) of the variation of ESRD (ESRD-DM) prevalence. This study may serve as a springboard for further investigation. Additional information, interventions, and resources are needed, particularly in the Southwest Hispanic region of the United States. Future annual reports from the US Renal Data System should include supplementary information on Hispanics.
Pazmiño
Patricio A
PA
Nephrology, Internal Medicine & Hypertension Center, NIH Center #101, 1701 N Mesa & Schuster, El Paso, TX 79902, USA.
Pazmiño
Alice K
AK
D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class; D013781:Texas / Q000453:epidemiology