Why is there so much end-stage renal failure of undetermined cause in UK Indo-Asians?

QJM. 2001 Apr;94(4):187-93. doi: 10.1093/qjmed/94.4.187.

Abstract

There is a high incidence of end-stage renal failure (ESRF) of undetermined cause in the Indo-Asian population of the UK. We studied patients presenting from the district of Brent and Harrow, which has a large Indo-Asian community, and whose renal services are largely provided by our centre. The diagnosis and ethnicity of patients starting renal replacement therapy and/or undergoing renal biopsy were collated. The incidences of ESRF, rates of renal biopsy and underlying diagnoses were calculated for Indo-Asians and Caucasians. Requirement for renal replacement therapy in Indo-Asians presenting to our centre from Brent and Harrow was 221/10(6)/year; no underlying diagnosis was identified in 77/10(6)/year. Renal biopsy rate in these patients was 456/10(6)/year, and the diagnostic categories significantly over-represented compared to Caucasians were: hypertension and ischaemia, focal segmental glomerulosclerosis (FSGS), idiopathic interstitial nephritis (IIN), diabetic nephropathy, minor glomerular abnormality, lupus nephritis and non-specific advanced chronic renal disease (p<0.001). The first three of these had a combined incidence of 135/10(6)/year in Indo-Asians and 31/10(6)/year in Caucasians. ESRF of undetermined cause is common in UK Indo-Asians, as is requirement for renal biopsy. Hypertension with ischaemia, FSGS and IIN are over-represented in the Indo-Asian population, and should be targeted for early diagnosis and treatment in this group.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Asia / ethnology
  • Biopsy / statistics & numerical data
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / ethnology
  • Diabetic Nephropathies / therapy
  • Glomerulosclerosis, Focal Segmental / complications
  • Glomerulosclerosis, Focal Segmental / ethnology
  • Glomerulosclerosis, Focal Segmental / therapy
  • Humans
  • Hypertension / complications
  • Hypertension / ethnology
  • Hypertension / therapy
  • Incidence
  • India / ethnology
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / therapy
  • Middle Aged
  • Nephritis, Interstitial / complications
  • Nephritis, Interstitial / ethnology
  • Nephritis, Interstitial / therapy
  • Renal Replacement Therapy / statistics & numerical data
  • United Kingdom / epidemiology