Effect of ethnicity on the progression of diabetic kidney disease independent of glycemic control.
OBJECTIVE
The prevalence of diabetic kidney disease (DKD) and risk of progression to end-stage renal disease is higher in African-Americans as compared to Caucasians. Whether the higher rate of estimated glomerular filtration rate (eGFR) decline in African-Americans is mediated by poor glycemic control is unclear.


METHODS
We conducted a prospective study of 183 (African-American, n = 95; Caucasian, n = 88, mean age 66 +/- 10 vs. 70 +/- 11 years) patients with a diagnosis of DKD followed over a period of 12 months. eGFR (ml/min/1.73 m(2)) was calculated by MDRD formula and grouped into stage 1-2 (> or =60 ml/min), stage 3 (30-60 ml/min) and stage 4 (<30 ml/min). In addition, glycosylated hemoglobin A1C (HbA1c) was categorized into tertiles (<7, 7-8 and >8%) at each time point.


RESULTS
There were no significant differences in eGFR at any time point between African-American and Caucasian in any stage of CKD during this period. There were also no significant differences in eGFR at any time point in each category of HbA1c.


CONCLUSIONS
Our data indicate that there were no ethnic differences in the rate of progression of DKD under equivalent glycemic control. Further research is needed to explore the mechanisms associated with higher prevalence and rapid progression of CKD in African-Americans compared to Caucasians.
Salifu
Moro O
MO
State University of New York Downstate Medical Center and Kings County Hospital Center, VA Medical Center, Brooklyn, NY, USA.
Shah
Syed
S
Iqbal
Muhammad H
MH
Nabi
Mushtaq
M
Hayat
Amir
A
Whaley-Connell
Adam T
AT
Sowers
James R
JR
McFarlane
Samy I
SI
D001741:Black or African American; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003928:Diabetic Nephropathies / Q000097:blood / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D044465:White People
D001786:Blood Glucose