Kidney Damage More Common Among Non–Whites

New York, NY (March 1, 2010) — Non-white individuals at high risk of kidney disease are more likely to show signs of kidney damage than whites from similar risk groups, new findings from the National Kidney Foundation's Kidney Early Evaluation Program (KEEP) show.

This damage is especially common among American Indians and Alaska Natives, who were nearly twice as likely as whites to have abnormal amounts of albumin, or protein, in their urine, Stacy Jolly, MD, of the Cleveland Clinic Medicine Institute in Cleveland, Ohio, and her colleagues found. This abnormality, known medically as albuminuria, is a key marker for the onset and progression of kidney disease, as well as heart disease.

KEEP is a free, community-based program that has screened more than 140,000 people at high risk for chronic kidney disease across the U.S. since its launch in 2000. In the current study, Dr. Jolly and her team looked at a subset of 64,161 KEEP participants whose kidneys were still filtering their blood effectively. The findings appear in the March issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

While 8 percent of whites had albuminuria, 11 percent of African Americans, 9 percent of Hispanics, 10 percent of Asians, and 15 percent of American Indians/Alaska Natives did. This translated to a 20 percent greater risk for Hispanics, a 40 percent greater risk for African-Americans and Asians, and a nearly doubled risk for American Indians and Alaska Natives.

When the researchers looked at study participants without diabetes or high blood pressure, they found no ethnic differences in albuminuria, except for in American Indians and Alaska Natives, who were still twice as likely as whites to have the abnormality.

Genetic and environmental factors could help explain the increased likelihood of albuminuria among American Indians, Dr. Jolly and her team say. Right now the Indian Health Service recommends screening for albuminuria in all Native American adults with diabetes, they add, and the current findings "strongly suggest" that screening be considered for all adults in this ethnic group.

Individuals are considered to be at high risk for chronic kidney disease if they have diabetes or hypertension, or they have a close relative with diabetes, hypertension, or kidney disease. Many people with chronic kidney disease aren't aware of it, notes Dr. Peter McCullough, vice chair of KEEP; he points out that about a quarter of the people identified as having kidney disease through KEEP were "completely unaware" that they had any kidney problems. "The majority of chronic kidney patients diagnosed have not seen a nephrologist and thus, the primary care physician may be unaware of it," he adds.

The National Kidney Foundation holds KEEP screenings in cities across the U.S. for those at risk. To learn more about chronic kidney disease, risk factors, or treatments, contact the National Kidney Foundation at www.kidney.org or (800)622-9010.