Increased prevalence of dialysis-dependent renal failure in ethnic minorities in the west Midlands

A total of 1038 adult patients with dialysis-dependent renal failure were treated at this centre between 1981 and 1991. Data on racial origin and primary renal diagnosis have been analysed in order to determine the prevalence of end-stage renal failure (ESRF) and its causes. Compared with Caucasians there was a greater proportion of Asians (P < 0.001) and Blacks (P < 0.001) with ESRF. The relative risk of ESRF in Asians compared with Caucasians was 1.76 (95% CI 1.46-2.10) and for Blacks 1.76 (95% CI 1.39-2.2). Hypertension/renal vascular disease and systemic lupus erythematosus were more frequent causes of ESRF in Blacks than in Caucasians (P < 0.005). Hypertension/vascular disease and tuberculosis were more frequent causes of ESRF in Asians than Caucasians (P < 0.005) respectively. Diabetes mellitus appeared to be more common as a cause of ESRF in Blacks than Asians or Caucasians (0.1 > P > 0.05). Adult polycystic disease was significantly less common in Asians compared to Caucasians and Blacks (P < 0.05). The prevalence of ESRF in Asians and Blacks in the West Midlands appears to be greater than that of Caucasians, mostly as a consequence of hypertension/vascular disease and to a lesser extent of systemic lupus erythematosus in Blacks and of tuberculosis in Asians. If these data are confirmed by prospective study then they have implications for service provision.