Higher Rates of Diabetic Kidney Disease in Minority Populations
Minorities have increased rates of proteinuric diabetic kidney disease compared to non-Hispanic whites, according to a collaborative study between the Palo Alto Medical Foundation (PAMF) Research Institute and Stanford University. The study led by PAMF’s Latha Palaniappan, M.D., and Stanford’s Vivek Bhalla, M.D., examined the prevalence of diabetic kidney disease in minority patients at the Palo Alto Medical Foundation. The results were published in the December 2012 online issue of Diabetes Care .
About 10 to 15 percent of adults with type 2 diabetes develop diabetic kidney disease. The kidneys filter and remove waste products from the blood, and can be damaged by high levels of blood sugar. Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. Patients with diabetes are monitored regularly for two signs of diabetic kidney disease: waste products found in the blood and proteins found in urine, known as proteinuria.
In the study, the researchers investigated racial/ethnic differences in diabetic kidney disease, with and without proteinuria.
“Most people think that diabetic kidney disease begins with proteinuria, when the damaged kidney allows proteins that should be kept within the body to leak into the urine. Actually 33 to 50 percent of people who are developing kidney disease do not test positive for protein in urine,” says Dr. Palaniappan.
Drs. Palaniappan and Bhalla analyzed the health information of adult patients with diabetes and no history of kidney disease from several racial/ethnic groups: non-Hispanic white, Asian Indian, Chinese, Filipino, Hispanic/Latino, and Black/African-American. They examined urine and blood laboratory results, along with other characteristics such as age, hemoglobin A1C, body mass index (BMI), blood pressure and cholesterol levels.
The study found that minorities have increased rates of proteinuric DKD, compared to non-Hispanic whites. Non-proteinuric DKD was less prevalent among minorities than among non-Hispanic whites. The study suggests that the higher rates may be related to race/ethnicity.
“For example, Filipinos are known to develop chronic kidney disease at higher rates than other racial/ethnic groups, which may be due to increased rates of diabetes,” explains Dr. Palaniappan. “However, even after adjusting for this in statistical analyses, kidney disease was still higher in Filipinos with diabetes relative to other Asian subgroups. This suggests that other factors, such as socioeconomic or cultural issues, dietary factors, or genetics, may play a unique role in this group.”
Overall, these results indicate that additional studies are needed, and that diabetic complications in minorities should be carefully monitored. Information from this study may inform future research and identify factors that may predict outcomes and responses to therapy among people with diabetes, chronic kidney disease, and diabetic kidney disease.