HIV Linked to Increased Risk of ESRD in African Americans

The American Society of Nephrology, in an article in the November Journal of the American Society of Nephrology, says a study reveals that African Americans infected with HIV are at six times the risk for ESRD than Caucasian Americans who are affected with HIV. ESRD stands for end-stage renal disease. The article states that the risk is similar to the ESRD risk associated with diabetes.

Dr. Andy I. Choi of the San Francisco General Hospital and University of California states that the study shows an unexpected degree of ESRD among HIV infected African Americans. He goes on to state that Caucasian people with HIV had rates of ESRD that were far lower than among blacks and that HIV among whites did not translate to a higher risk of ESRD. Dr. Choi states, " We can think of few other risk factors for ESRD that are modified to this extent by race".

The study was done using data from more than 2 million veterans and was supplied by the Veteran's Administration. The 2 million veterans underwent kidney function tests in 2000 and 2001. In 2004, the same veterans were studied to identify person's who had developed ESRD. ESRD is defined as a "permanent loss of kidney function requiring dialysis or kidney transplantation".

The press release states that the study was designed to evaluate HIV as being a risk factor for ESRD. Of the 2 million veterans, about 15,000 had HIV and fifty four percent of the HIV-positive veterans were African Americans.

For white veterans, HIV was not shown to increase ESRD risk, but the risk for those with diabetes were nearly doubled. Diabetes is still the main risk factor for ESRD among whites.

However, African Americans with HIV showed nearly twice the risk for ESRD than African Americans patients without HIV or diabetes. For African Americans with diabetes, ESRD risk was also twice as high.

For both groups of Americans, ESRD risk is somewhat higher when both HIV and diabetes are present.

Even after an adjustment for other factors, the risk of ESRD among blacks with HIV was six times as high as for whites with HIV, making the risk for blacks with HIV as strong a risk factor for ESRD as diabetes.

According to the press release, kidney disease is a growing problem for those infected with HIV; kidney disease has increased greatly during recent years among HIV patients. Dr. Choi states, "While we know that HIV infection can cause kidney disease, few studies have quantified the risk of ESRD associated with HIV". Dr. Choi says that the reasons for white patients with HIV being at less risk for ESRD are unclear.

Researchers are hoping to draw attention to the sharp increase of kidney disease in the HIV infected community. The incidence of kidney disease among the HIV infected is reported to be very high, according to the press release. Dr. Choi states, "The findings highlight the importance of efforts to improve the management of kidney disease among black patients with HIV infection." He goes on to say, "The pronounced race-dependence of HIV as a risk factor for ESRD also suggests that HIV may serve as a model for understanding racial differences in progression of kidney disease".

The study is entitled, "Racial Differences in End Stage Renal Disease Rates Among U.S. Veterans with HIV versus Diabetes". It will be on line under media, at www.asn-online.org Wednesday October 17. It will be one of the articles in the November issue of the American Journal of the American Society of Nephrology.

The ASN is a non profit organization with 10,000 physicians and scientists who study nephrology. The organization is also a forum for reporting the latest information about research and clinical findings regarding kidney disease.

Other sources used for this article: http://www.newswise.com