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Diabetic kidney disease in Pima Indians
R G Nelson1, W C Knowler, D J Pettitt
1Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Phoenix, AZ 85016.
Diabetes Care
|January 1, 1993
Summary
Diabetic kidney disease is a significant health issue for Pima Indians with non-insulin-dependent diabetes mellitus (NIDDM). This condition leads to high rates of kidney failure and mortality in this population.
Area of Science:
- Nephrology
- Endocrinology
- Epidemiology
Background:
- Non-insulin-dependent diabetes mellitus (NIDDM) is a leading cause of end-stage renal disease (ESRD) in Pima Indians.
- The incidence of ESRD in Pima Indians with NIDDM is notably higher than in the general U.S. population.
Purpose of the Study:
- To elucidate the natural history of kidney disease in Pima Indians diagnosed with NIDDM.
- To compare the progression and outcomes of diabetic kidney disease in Pima Indians with other populations.
Main Methods:
- A comprehensive review of existing studies on diabetic kidney disease in Pima Indians and other demographic groups.
- Analysis of data pertaining to the incidence of nephropathy and ESRD in relation to diabetes duration and other risk factors.
Main Results:
- NIDDM is the primary driver of renal failure in Pima Indians, with ESRD incidence 23 times greater than the general U.S. population.
- The progression of overt nephropathy and ESRD in Pima Indians with NIDDM is comparable to that observed in individuals with insulin-dependent diabetes mellitus (IDDM) in other populations.
- Elevated urinary albumin excretion (UAE), hypertension, glycemia levels, diabetes duration, family history, and treatment type are key predictors of diabetic kidney disease progression.
Conclusions:
- Diabetic kidney disease represents a substantial burden of illness and mortality among Pima Indians.
- The natural course of diabetic kidney disease in Pima Indians shares significant similarities with that observed in individuals with IDDM.