New-onset chronic kidney disease (CKD) in people with diabetes is higher among racial and ethnic minority groups compared with white people, according to a UCLA-Providence study.
The study, published as a letter to the editor in the New England Journal of Medicine, found that rates of CKD onset were approximately 60%, 40%, 33% and 25% higher in Native Hawaiian/Pacific Island, Black, American Indian/Alaska Native and Hispanic/Latino populations, respectively, compared with white people with diabetes.
Although the high incidence of CKD in diabetes persists, the rate has dropped from 8% of the general population with diabetes in 2015-2016 to 6.4% in 2019-2020.”
“The results of our study constitute a call to action to institute focused and targeted efforts aimed at deliberately changing the trajectory of persistently high rates of CKD and diabetes-related kidney failure that disproportionately affect racial and ethnic minority groups,” said co-authors. Dr. Susanne Nicholas, associate professor of medicine in the division of nephrology at the UCLA David Geffen School of Medicine and chair of the UCLA Racial Equity and Health Committee of Nephrology. “The first step should be to increase screening and detection rates for CKD in individuals with diabetes.”
Researchers from the Geffen School, Providence, and Centers for Disease Control and Prevention tracked 654,549 adults with diabetes from 2015 to 2020 using electronic health records from Providence Health and UCLA Health, two large nonprofit health care systems serving the western United States. United States .
The prevalence of kidney failure requiring dialysis or a transplant more than doubled for nearly 800,000 people in the United States between 2000 and 2019, with diabetes the leading cause. The rate of CKD onset in people with diabetes was previously unknown, but the value of these incidence data is vital for identifying high-risk populations, determining the effectiveness of interventions, and assessing effects on health care delivery and health responses. public. Even more impressive, less than 10% of patients with early-stage kidney disease are aware of having CKD at this stage of its progression, when therapies are most effective.
“Given the rapidly growing population with diabetes in the United States and correspondingly high rates of renal failure, the persistently high incidence of CKD marked by racial and ethnic disparities is concerning,” said lead author Dr. Katherine Tuttle, executive director of research at Providence Inland Northwest Health and professor of medicine at the University of Washington. “Inclusive strategies for prevention, detection and intervention are needed to reduce the risk of CKD in people with diabetes.”
Additional study authors include Drs. Dr. O. Kenrik Duru and Dr. Keith Norris of UCLA; Cami Jones, Kenn Daratha; Radica Alicic and Joshua Neumiller of Providence; and Nilka Rios Burrows, Alain Koyama and Dr. Nilka Rios Burrows. Meda Pavkov of the Centers for Disease Control and Prevention.
New England Journal of Medicine
Incidence of chronic kidney disease among adults with diabetes, 2015-2020
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