End stage kidney disease: increasing incidence in Virginia

The incidence of new cases of end stage renal disease (ESRD) in Virginia increased an average of 14.5% annually from 1988 through 1991, producing a parallel increase in expenditures for the ESRD program. Hypertension (34%) and diabetes mellitus (32%) are the most frequent causes of ESRD in Virginia, with highest incidence among Afro-Americans and the elderly. Physicians should be aware of those at risk for ESRD so that reversible causes of renal failure can be identified and corrected. In addition, they should know which drugs to prescribe and which to avoid. Better detection and management of high blood pressure and diabetes mellitus can slow progressive renal failure and make a difference in the incidence of ESRD in Virginia during the coming years.