Further trends in the etiology of end-stage renal disease in African-Americans

Publications in the past year have continued to shed light on the etiology of the excess risk of end-stage renal disease end-stage renal disease among African-Americans. Prospective data now show that even mild elevations in blood pressure are associated with an increased risk of end-stage renal disease. The prevalence of hypertension among African-Americans has been declining, but remains much higher than among White people. Management of hypertension is the best avenue to prevent much of the excess burden of end-stage renal disease, but the relative merits of different agents and levels of blood pressure control are still under study, In addition, individuals with human immunodeficiency virus-related end-stage renal disease represent a small but rapidly growing number of patients that are predominantly African-American. Studies are underway to examine ethnic differences and risk factors for the earlier stages of renal disease as well as genetic mutations for non-Mendelian forms of end-stage renal disease.