Tell G S, Hylander B, Craven T E, Burkart J
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Ethn Health. 1996 Mar;1(1):21-31. doi: 10.1080/13557858.1996.9961767.
To examine trends in the incidence of treated end-stage renal disease (ESRD) and variations between blacks and whites.
Retrospective record reviews of all new patients > or = 15 years starting chronic dialysis during 1980-1988 at the Piedmont Dialysis Center, Forsyth County, North Carolina.
The cumulative nine-year incidence rate for hypertensive ESRD was 570 per million, and for diabetic ESRD 497 per million. Among men, hypertensive ESRD accounted for the largest proportion of cases (39.2% and 28.4%, blacks and whites respectively), while diabetic ESRD contributed 33.9% of black female cases and 24.4% of white female cases. Compared to whites, blacks were at significantly increased risk, with an adjusted risk odds ratio (OR) of 4.4 (95% confidence interval (CI) 3.5-6.0) for all causes combined, 6.0 (CI 3.9-9.0) for hypertensive renal disease, 6.0 (CI 3.8-9.3) for renal disease due to insulin-dependent diabetes mellitus, and 12.2 (CI 6.9-21.7) due to non-insulin dependent diabetes mellitus (NIDDM). The greatest risk among blacks was seen in the 55-64 year age group, with ORs of 9.1 for all causes combined and 30.6 for hypertensive renal disease. The OR for renal disease due to NIDDM for black versus white women was 20.0 (CI 9.5-41.7). Compared to 1980, 1981, 1982 and 1983, increased incidence rates were seen in each year after 1984.
These findings show even greater excess risk of ESRD among blacks than previously reported. The majority of the excess risk is seen for ESRD due to hypertension and diabetes, especially NIDDM. The reasons for the increased risk among blacks, and for the increasing incidence rates of ESRD are not known.
研究接受治疗的终末期肾病（ESRD）的发病率趋势以及黑人和白人之间的差异。
对1980 - 1988年期间在北卡罗来纳州福赛思县皮埃蒙特透析中心开始进行慢性透析的所有年龄≥15岁的新患者进行回顾性记录审查。
高血压性ESRD的累积九年发病率为每百万570例，糖尿病性ESRD为每百万497例。在男性中，高血压性ESRD占病例的最大比例（黑人中占39.2%，白人中占28.4%），而糖尿病性ESRD在黑人女性病例中占33.9%，在白人女性病例中占24.4%。与白人相比，黑人的风险显著增加，所有原因综合调整后的风险比值比（OR）为4.4（95%置信区间（CI）3.5 - 6.0），高血压肾病为6.0（CI 3.9 - 9.0），胰岛素依赖型糖尿病所致肾病为6.0（CI 3.8 - 9.3），非胰岛素依赖型糖尿病（NIDDM）所致肾病为12.2（CI 6.9 - 21.7）。黑人中最大风险出现在55 - 64岁年龄组，所有原因综合的OR为9.1，高血压肾病为30.6。黑人与白人女性相比，NIDDM所致肾病的OR为20.0（CI 9.5 - 41.7）。与1980年、1981年、1982年和1983年相比，1984年后每年的发病率都有所上升。
这些发现表明，黑人中ESRD的额外风险比之前报道的更大。大部分额外风险见于高血压和糖尿病所致的ESRD，尤其是NIDDM。黑人风险增加以及ESRD发病率上升的原因尚不清楚。
