The effect of ethnicity on the prevalence of diabetes and associated chronic kidney disease

• Published in: QJM : An International Journal of Medicine Vol. 102; no. 4; pp. 261 - 269
• Main Authors: Dreyer, G., Hull, S., Aitken, Z., Chesser, A., Yaqoob, M.M.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-04-2009; Oxford Publishing Limited (England)
• Subjects: Adult; Biological and medical sciences; Chronic Disease; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - therapy; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - ethnology; Diabetic Angiopathies - therapy; Diabetic Nephropathies - epidemiology; Diabetic Nephropathies - ethnology; Diabetic Nephropathies - therapy; Epidemiology; Female; General aspects; Humans; Kidney Diseases - epidemiology; Kidney Diseases - ethnology; Kidney Diseases - therapy; Male; Medical sciences; Practice Guidelines as Topic; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Severity of Illness Index; United Kingdom; Endocrinopathy; Kidney disease; Medicine; Ethnic origin; Urinary system disease; Prevalence; Diabetes mellitus; Renal failure; Chronic kidney disease; Epidemiology; Ethnic group
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcn177

Background: The effect of ethnicity on the prevalence of diabetes mellitus (DM) and associated chronic kidney disease (CKD) is unknown. Aim: To establish the impact of ethnicity on the prevalence and severity of diabetes mellitus and associated CKD. Design: Cross-sectional study of 34 359 adult diabetic patients in three primary care trusts in the UK. Methods: Read coded data from general practice computers was used to analyse the relationship between ethnicity, DM and CKD. Results: The prevalence of DM was 3.5% for Whites, 11% for South Asians and 8% for Black groups. The prevalence of CKD (stages 3–5) among diabetics was 18%. CKD stage 3 was more prevalent in Whites compared to South Asians—OR 0.79 (95% CI: 0.71–0.87) and Blacks—OR 0.49 (95% CI: 0.43–0.57). Among all CKD patients severity (CKD stages 4, 5) was associated with Black (OR 1.39, 95% CI: 1.06–1.81) and South Asian (OR 1.54, 95% CI: 1.26–1.88) ethnicity compared to Whites. Less than 50% of diabetics with CKD met the target blood pressure (BP) of 130/80 mmHg. The prevalence of a blood pressure > 150/90 mmHg in diabetics with CKD was South Asian 15.6%, White 13.9%, Black 21.8% (P < 0.001). Proteinuria was present in 8.6% of all diabetic patients. However, this increased to 18.6% in patients with CKD, and was more frequent in Black (22.6%) and South Asian (21%) patients compared to White patients (14.1%) (P < 0.001). Conclusions: Significant disparities exist between the major ethnic groups in both disease prevalence and management. Future studies examining the management of CKD need to take variation by ethnicity into account.