Background: AA have a higher prevalence of diabetic nephropathy (DN) than Caucasians. However, the prevalence of DN between AA and Caucasians as a function of time is less well understood.
Methods: We retrospectively reviewed the medical charts of 1211 adults who consecutively presented to our diabetes clinic from 2001-10. We collected data from their initial clinic visit. We defined DN as microalbuminuria >300 mg/g or GFR <60 mL/min/1.73m2. Primary objectives were to estimate the prevalence of DN among AA and Caucasians, estimate DN prevalence as a function of time since diabetes diagnosis, and determine risk factors associated with DN.
Findings: The prevalence of DN among AA and Caucasians was 32% and 19.6%, respectively. The prevalence of DN increased as a function of time for both AA and Caucasians, but was significantly higher among AA >10 years after diabetes diagnosis (Figure). In multivariable logistic regression, having hypertension (OR = 3.0, 95% CI 2.03 - 4.49), diabetes for >10 years (2.64, 1.91 - 3.68), A1c >8% (1.40, 1.01 - 1.96), and being AA (1.88, 1.32 - 2.66) were independently associated with DN. Diabetes subtype, BMI, and gender were not associated with DN.
Interpretation: Differences in DN prevalence between AA and Caucasians appear ∼10 after diabetes diagnosis, independent of A1c and hypertension control. AA may benefit from early prevention and aggressive risk factors control.
A. De Ferrari: None. F. Ovalle: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Novo Nordisk A/S.