August 9, 1999Archives of Internal Medicine
A Community-Based Study of Explanatory Factors for the Excess Risk for Early Renal Function Decline in Blacks vs Whites With Diabetes
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Discussion
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Implication
Prospective cohort study observes elevated early kidney decline in Black adults with diabetes, indicating modifiable socioeconomic and clinical risk factors drive the disparity.
Key Points
- To compare the incidence of early renal function decline between Black and White adults with diabetes and determine the factors explaining racial disparities.
- Prospective cohort study of 1,434 diabetic adults aged 45 to 64 years recruited from four US communities within the Atherosclerosis Risk in Communities (ARIC) study.
- Tracked participants over 3 years of follow-up to detect early renal function decline, defined as an increase in serum creatinine of at least 35.4 µmol/L (0.4 mg/dL).
- Early renal function decline developed in 45 Black participants (28.4 per 1,000 person-years) and 25 White participants (9.6 per 1,000 person-years).
- Adjusting for age, sex, and baseline serum creatinine showed higher odds of decline in Black adults (OR 3.15; 95% CI, 1.86–5.33).
- Further adjustment for socioeconomic status, health behaviors, blood glucose, and blood pressure reduced the odds ratio to 1.38 (95% CI, 0.71–2.69), explaining approximately 82% of the excess risk.
Cite This Study
Krop et al. (1999) studied this question.