Urinary protein excretion may contribute to increased risk of kidney failure in blacks

Treatments could lower kidney failure risk for all

African Americans are four times more likely to develop kidney failure than whites. A new study has found that a condition that occurs when the kidneys are damaged and spill protein into the urine contributes to this increased risk.

The study, conducted by William McClellan, MD of Emory University and his colleagues, appears in an upcoming issue of the Journal of the American Society Nephrology (JASN), a publication of the American Society of Nephrology.

The investigators analyzed information from 27,911 individuals (40.5% of whom were African Americans). Among the major findings:

• After an average follow-up of 3.6 years, 133 individuals developed kidney failure.
• There were 96 cases of kidney failure among African Americans and 37 among whites.
• Kidney failure was most common in individuals who excreted large amounts of protein in their urine.
• African Americans were more likely to excrete large amounts of protein in their urine than whites.

The investigators speculate that several factors may explain why African Americans tend to excrete more protein in their urine. These could include blood pressure and other heart-related factors, obesity, smoking, vitamin D levels, genetic differences, income, and birth weight. These factors may act at different times during an individual's life to affect kidney health.

"Our large nationwide study brings attention to higher levels of urinary protein excretion as important contributors to the increased incidence of kidney failure experienced by blacks," said Dr. McClellan. Treating urinary protein excretion may help reduce racial disparities related to kidney failure as well as reduce the rate of progression to kidney failure for all individuals.

Source: American Society of Nephrology