The effect of ethnicity on the prevalence of diabetes and associated chronic kidney disease.
BACKGROUND
The effect of ethnicity on the prevalence of diabetes mellitus (DM) and associated chronic kidney disease (CKD) is unknown.


OBJECTIVE
To establish the impact of ethnicity on the prevalence and severity of diabetes mellitus and associated CKD.


METHODS
Cross-sectional study of 34 359 adult diabetic patients in three primary care trusts in the UK.


METHODS
Read coded data from general practice computers was used to analyse the relationship between ethnicity, DM and CKD.


RESULTS
The prevalence of DM was 3.5% for Whites, 11% for South Asians and 8% for Black groups. The prevalence of CKD (stages 3-5) among diabetics was 18%. CKD stage 3 was more prevalent in Whites compared to South Asians--OR 0.79 (95% CI: 0.71-0.87) and Blacks--OR 0.49 (95% CI: 0.43-0.57). Among all CKD patients severity (CKD stages 4, 5) was associated with Black (OR 1.39, 95% CI: 1.06-1.81) and South Asian (OR 1.54, 95% CI: 1.26-1.88) ethnicity compared to Whites. Less than 50% of diabetics with CKD met the target blood pressure (BP) of 130/80 mmHg. The prevalence of a blood pressure > 150/90 mmHg in diabetics with CKD was South Asian 15.6%, White 13.9%, Black 21.8% (P < 0.001). Proteinuria was present in 8.6% of all diabetic patients. However, this increased to 18.6% in patients with CKD, and was more frequent in Black (22.6%) and South Asian (21%) patients compared to White patients (14.1%) (P < 0.001).


CONCLUSIONS
Significant disparities exist between the major ethnic groups in both disease prevalence and management. Future studies examining the management of CKD need to take variation by ethnicity into account.
Dreyer
G
G
Renal Department, Barts and the London NHS trust, London, E1 1BB, UK. Gavin.Dreyer@bartsandthelondon.nhs.uk
Hull
S
S
Aitken
Z
Z
Chesser
A
A
Yaqoob
M M
MM
D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy; D008297:Male; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012720:Severity of Illness Index; D006113:United Kingdom