WASHINGTON—African Americans with hypertensive nephrosclerosis are more likely to develop end-stage renal disease (ESRD) than to die prematurely, according to a study appearing online July 22 in the Journal of the American Society of Nephrology (JASN).
Earlier studies have shown that patients of all races with chronic kidney disease (CKD) were at greater risk of dying prematurely from cardiovascular disease (CVD) than reaching ESRD. Hypertensive nephrosclerosis (also called hypertensive CKD) is a common kidney disorder in which the smallest arteries in the kidneys, called the arterioles, are damaged. This type of damage can be benign, which means it occurs over a period of years. While it often does not lead to kidney failure, in some patients this form of kidney disease progresses very quickly and the patient develops kidney failure.
Hypertensive nephrosclerosis accounts for about 1/3 of new cases of kidney failure in African Americans.
Tahira Palmer Alves MD, MPH, of the University of Texas Health Science Center at San Antonio, senior author Julia Lewis, MD, of Vanderbilt University, Nashville, and colleagues studied participants from the African American Study of Kidney Disease and Hypertension (AASK) trial and cohort phase. The AASK trial had 1,094 participants enrolled, 764 (70 percent) of whom completed the trial phase without an event and 691 of those (90 percent), subsequently enrolled in the cohort phase.
“The results may provide new insights into the relationship between high blood pressure and kidney disease in African Americans, as well as some of the reported racial differences in the rates and outcomes of ESRD,” said Alves.
African Americans are at increased risk of kidney failure caused by hypertension. The African American Study of Kidney Disease and Hypertension (AASK) Cohort Study was created to identify risk factors for progressive kidney disease in African Americans with hypertensive chronic kidney disease in the setting of recommended antihypertensive therapy.
Alves noted that AASK allowed the medical community to gain a greater understanding of the types of serious health outcomes (ESRD, CVD events, and mortality) that afflict African-Americans with nondiabetic hypertensive nephrosclerosis.
