Original Report: Patient-Oriented, Translational Research

Effect of Ethnicity on the Progression of Diabetic Kidney Disease Independent of Glycemic Control
Moro O. Salifu^a, Syed Shah^a, Muhammad H. Iqbal^a, Mushtaq Nabi^a, Amir Hayat^a, Adam T. Whaley-Connell^b, James R. Sowers^b, Samy I. McFarlane<sup>a

a</sup>State University of New York Downstate Medical Center and Kings County Hospital Center, VA Medical Center, Brooklyn, N.Y., and
^bUniversity of Missouri-Columbia School of Medicine and Harry S. Truman VA Medical Center, Columbia, Mo., USA

Address of Corresponding Author

Am J Nephrol 2009;30:261-267 (DOI: 10.1159/000223527)

  Key Words

• Diabetic kidney disease, ethnicity
• Glycemic control

  Abstract

Background/Aims: 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 m²) was calculated by MDRD formula and grouped into stage 1–2 (≥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.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Prof. Samy I. McFarlane
College of Medicine, State University of New York Downstate Medical Center
450 Clarkson Avenue, Box 50, Brooklyn, NY 11203 (USA)
Tel. +1 718 270 3711, Fax +1 718 270 6358
E-Mail samy.mcfarlane@downstate.edu

  Article Information

Received: February 10, 2009
Accepted: April 23, 2009
Published online: June 4, 2009
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 2, Number of References : 38