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Kidney Disease Progresses Faster in African Americans than Other Races

RESEARCH TRIANGLE PARK, N.C. — Among individuals with chronic kidney disease, African Americans experience faster progression of the disease during later stages compared with other races, according to a study by researchers at RTI International and colleagues.

The study, published online in the Journal of the American Society of Nephrology found that screening of African Americans with chronic kidney disease can help improve care and is cost-effective.

African Americans have a similar prevalence of chronic kidney disease as other Americans, but they are more likely to progress to kidney failure. The lifetime incidence of kidney failure is about 8.6 percent for African Americans compared with 3.5 percent for other Americans. The reasons for this disparity are not known.

The researchers used a simulation model of chronic kidney progression to see if the prevalence of common chronic kidney disease risk factors (such as high blood pressure and diabetes) could explain the higher lifetime incidence of kidney failure among African Americans.

The researchers found that the higher lifetime incidence of kidney failure among African Americans was not fully explained by the prevalence of common chronic kidney disease risk factors. Instead, it could be explained by faster progression of chronic kidney disease among African Americans during the later stages of the disease.

The investigators then considered whether screening for a particular marker of chronic kidney disease called microalbuminuria—when the kidneys leak small amounts of protein into the urine—would be cost-effective.

“We found that screening for microalbuminuria is cost-effective for African Americans at either five- or 10-year intervals, particularly for those with diabetes or hypertension,” said Thomas Hoerger, Ph.D., a senior fellow and director of the RTI-UNC Center for Excellence in Health Promotion Economics at RTI. “Screening could lead to earlier treatment that might prevent kidney failure.”