Abstract: SA-PO542
Incidence in Kidney Failure from Diabetes Among Native Americans, 2000-2016
Session Information
- Diabetic Kidney Disease: Pathology, Epidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 601 Diabetic Kidney Disease: Basic
Authors
- Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Zhang, Yan, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Hora, Israel, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Imperatore, Giuseppina, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Background
Diabetes-related end-stage renal disease (ESRD-D) among Native Americans (NAs) declined from 1996 to 2013. We assessed recent data to determine if the rates have continued to decline.
Methods
From the US Renal Data System, we obtained the number of NA adults and adults of other races (whites, blacks, Asians, Native Hawaiians/Pacific Islanders, and others) aged ≥18 years with newly treated ESRD-D (with diabetes listed as primary cause of ESRD) between 2000 and 2016. ESRD-D rates by age and sex were calculated using general population estimates from the US Census and age-adjusted based on the 2000 US standard population. Joinpoint regression was used to assess trends and estimate the annual percentage change (APC).
Results
From 2000 to 2016, the number of US adults starting ESRD-D therapy decreased from 878 to 825 for NAs and increased from 40,632 to 56,170 for other races. For NAs, the age-adjusted ESRD-D rate decreased from 66.7 per 100,000 population in 2000 to 30.3 in 2013 (APC= -5.6%, p<0.001) and then leveled off (Figure). Trends for NA men and women were similar to the overall trend. For other races, the age-adjusted rate increased slightly from 2000 to 2006 (from 19.7 to 20.7, APC=0.6%, p=0.04), decreased from 2006 to 2012 (20.7 to 19.1, APC= -1.1%, p=0.007), and again increased from 2012 to 2016 (19.1 to 20.3, APC=1.5%, p=0.009). By age group, ESRD-D rates showed no change for NAs aged 18-44 (from 7.7 in 2000 to 7.6 in 2016), declined for NAs aged 45-64 (from 108.3 in 2000 to 45.2 in 2013, APC= -5.8%, p<0.001) and 65-74 (from 231.2 in 2000 to 88.6 in 2012, APC= -7.6%, p<0.001) and then leveled off, and declined throughout the period for NAs aged ≥75 (119.3 to 61.9, APC= -4.2%, p<0.001).
Conclusion
From 2000 to 2016, ESRD-D continued to decline in NAs aged ≥75 years but, after an initial decline, has leveled off in more recent years in NAs aged 45-74 years. During the period, the disparity gap between NAs and other races was reduced more than 2-fold. Continued efforts might be considered to sustain and improve ESRD-D trends in NAs.
Funding
- Government Support - Non-U.S.