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US kidney failure rates stabilize, ending a 20-year climb

After 20 years of annual increases from 5 to 10 percent, rates for new cases of kidney failure have stabilized, according to new research from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health. At the same time, dramatic racial disparities persist.

In 2003, the rate for new cases of kidney failure was 338 per million population, down slightly from 2002 and continuing a four-year trend, finally allowing researchers to be cautiously optimistic that rate decreases have not happened by chance. The average annual increase has been less than 1 percent since 1999, compared to an average 5 percent in the previous decade, according to research published recently by NIDDK's U.S. Renal Data System (USRDS) at www.usrds.org and being presented next month at the annual scientific meeting of the American Society of Nephrology.

Diabetes and high blood pressure remain the leading causes of kidney failure, accounting for 44 percent and 28 percent of all new cases, respectively. The most striking trends were found in diabetes, where rates for new cases in whites under age 40 were the lowest since the late 1980's, in stark contrast to rates for their African American counterparts, which have not budged.

"It's gratifying to see progress, however small, and to know that NIDDK activities undoubtedly have had a hand in that success," said Paul W. Eggers Ph.D., NIDDK's co-director for the USRDS. "But persistent disparities are sobering."

Credit for recent gains likely goes to clinical strategies proven in the 1990s to significantly delay or prevent kidney failure: angiotensin-converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs), which lower protein in the urine and are thought to directly prevent injury to the kidneys' blood vessels; and careful control of diabetes and blood pressure. The launch of private and government programs to improve care and
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Contact: Mary M. Harris
Mary_Harris@nih.gov
301-435-8114
NIH/National Institute of Diabetes and Digestive and Kidney Diseases
11-Oct-2005


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