Hypertension and renal dysfunction: NHANES III.

The incidence rate of end-stage renal disease has increased in many countries in the past 20 yr, including the United States and Singapore. The increase in ESRD incidence in the United States is primarily attributable to diabetes and to hypertension. In Singapore the major cause of ESRD is diabetes, however the prevalence of hypertension in the Singapore population is rising rapidly, and renal complications of hypertension may become more common in the future. Information on the association of hypertension with renal dysfunction and ESRD in the United States may be useful in predicting future trends in the incidence of ESRD due to hypertension in Singapore. This paper describes published and unpublished data presented at a conference to assist in developing plans for a comprehensive renal disease prevention program in Singapore. It compares recent data on the reported prevalence of hypertension in the United States and Singapore; and presents information on the association of hypertension with serum creatinine, urinary albumin excretion, and ESRD in the United States.