Duru Obidiugwu Kenrik, Li Suying, Jurkovitz Claudine, Bakris George, Brown Wendy, Chen Shu-Cheng, Collins Allan, Klag Michael, McCullough Peter A, McGill Janet, Narva Andrew, Pergola Pablo, Singh Ajay, Norris Keith
Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Am J Kidney Dis. 2008 Feb;51(2):192-8. doi: 10.1053/j.ajkd.2007.09.023.
African American men with chronic kidney disease (CKD) progress to end-stage renal disease more rapidly than African American women or whites. Uncontrolled hypertension worsens CKD, and disparities in hypertension control may contribute to disparities in CKD progression.
Cross-sectional.
SETTING & PARTICIPANTS: 10,827 individuals with CKD and self-reported hypertension screened in the Kidney Early Evaluation Program.
African American race, sex.
Hypertension control (blood pressure <130 mm Hg systolic and/or <80 mm Hg diastolic).
Self-report, physical examination (blood pressure), laboratory data (serum creatinine, microalbuminuria by urine dipstick). We calculated estimated glomerular filtration rates by using the 4-variable isotope dilution mass spectrometry Modification of Diet in Renal Disease Study equation. We classified CKD as early (stages 1 to 2) or late (stages 3 to 5) based on estimated glomerular filtration rate and microalbuminuria.
In individuals with early CKD, African American women (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.14 to 1.88), white men (OR, 1.85; 95% CI, 1.39 to 2.46), and white women (OR, 1.69; 95% CI, 1.28 to 2.22) had greater odds of hypertension control (blood pressure <130/80 mm Hg) than African American men. In individuals with late CKD, white men (OR, 1.66; 95% CI, 1.10 to 2.52) and white women (OR, 1.67; 95% CI, 1.13 to 2.46) had greater odds of hypertension control than African American men. No differences were seen between African American men and women with late CKD.
No information for medication regimens.
African American men with CKD have poorly controlled hypertension compared with African American women and whites, particularly in the early stages of disease. Efforts to aggressively treat hypertension in this population may help narrow the race and sex disparities in progression to end-stage renal disease.
患有慢性肾脏病（CKD）的非裔美国男性比非裔美国女性或白人更快进展至终末期肾病。未控制的高血压会使CKD恶化，而高血压控制方面的差异可能导致CKD进展的差异。
横断面研究。
在肾脏早期评估项目中筛查的10827名患有CKD且自我报告有高血压的个体。
非裔美国人种族、性别。
高血压控制情况（收缩压<130 mmHg和/或舒张压<80 mmHg）。
自我报告、体格检查（血压）、实验室数据（血清肌酐、尿试纸法检测微量白蛋白尿）。我们使用四变量同位素稀释质谱法的肾脏病膳食改良研究方程计算估计肾小球滤过率。根据估计肾小球滤过率和微量白蛋白尿，我们将CKD分为早期（1至2期）或晚期（3至5期）。
在早期CKD患者中，非裔美国女性（比值比[OR]，1.47；95%置信区间[CI]，1.14至1.88）、白人男性（OR，1.85；95% CI，1.39至2.46）和白人女性（OR，1.69；95% CI，1.28至2.22）比非裔美国男性有更高的高血压控制（血压<130/80 mmHg）几率。在晚期CKD患者中，白人男性（OR，1.66；95% CI，1.10至2.52）和白人女性（OR，1.67；95% CI，1.13至2.46）比非裔美国男性有更高的高血压控制几率。晚期CKD的非裔美国男性和女性之间未观察到差异。
未提供药物治疗方案的信息。
与非裔美国女性和白人相比，患有CKD 的非裔美国男性高血压控制不佳，尤其是在疾病的早期阶段。积极治疗该人群高血压的努力可能有助于缩小种族和性别在进展至终末期肾病方面的差异。
