Kidney Disease Worsened in One-Quarter of Black Patients Despite Receiving Medication, Study Finds
Despite receiving kidney-protecting medication and maintaining good blood pressure, the kidneys of about one-fourth of black patients with chronic kidney disease caused by hypertension continued to deteriorate, according to a study published in the April 28 issue of the Archives of Internal Medicine, the New York Times reports (Nagourney, New York Times, 5/6).
The African-American Study of Kidney Disease and Hypertension Cohort Study is the largest and longest study on the disease in blacks, according to NIH, which led the research with funding through the agency's National Institute of Diabetes and Digestive and Kidney Diseases. For the study, Lawrence Agodoa of NIDDK and colleagues from 2002 to 2007 followed 750 black patients receiving recommended hypertension therapy for chronic kidney disease. Nearly nine out of 10 participants took an ACE inhibitor or an angiotensin receptor blocking drug, and participants' average blood pressure was close to national guidelines for high blood pressure in chronic kidney disease patients, according to an NIH release.
Researchers found that kidney disease significantly worsened in about one-fourth of the participants. However, the study also found that about one-third of the participants experienced a slow decline in kidney function, in line with "what is generally observed with aging," according to the release. Agodoa said more research is needed to determine what contributed to the smaller loss of kidney function in this group (NIH release, 5/5).
Researchers said the findings do not suggest that patients with chronic kidney disease tied to high blood pressure should not be administered the medication because, without the therapy, participants likely would have experienced a more significant decline in kidney function. The findings demonstrate the difficulty of finding an effective treatment for kidney disease and suggest that other factors beside high blood pressure need to be addressed, researchers said (New York Times, 5/6).
An abstract of the study is available online.
Milwaukee Kidney Donation Effort
In other news, the Wisconsin Donor Network, through several outreach and publicity campaigns, has "improved dramatically" the number of organ donors in the Milwaukee black community, Jay Campbell, director of WDN, writes in a Milwaukee Journal Sentinel opinion piece. Blacks experience disproportionately high rates of kidney disease caused by hypertension, and they are more likely to need transplants or dialysis than any other race, according to Campbell.
Blacks account for 35% of those in need of an organ transplant in Wisconsin, but blacks in Milwaukee historically "have resisted donation," Campbell writes. However -- through programs developed by WDN in conjunction with government officials, educational institutions, black-owned businesses, the media and black churches -- "the response to organ donation improved dramatically" in the past three years, he writes. WDN's approach also included hiring black employees and adopting a "serve the family first" policy that respects the family's decision, regardless of whether they decide to donate.
According to Campbell, 70% of blacks in the city agreed to a request to donate a family member's organs at the time of death in 2007, up from 20% in 2005, before the program began. Black organ donors increased from eight in 2005 to 12 in 2006 and to 30 in 2007, he said, adding, "Each of those organ donors saved nearly three lives. In less than two years, about 75 lives were saved by the [black] community in Milwaukee" (Campbell, Milwaukee Journal Sentinel, 5/3).