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| |  Kidney Disease Substantially Worsens in One-Fourth of African Americans Despite Hypertension Treatment BETHESDA, Md -- May 6, 2008 -- The best available treatment for chronic kidney disease from hypertension did not keep the disease from substantially worsening in about one-quarter of African Americans studied, according to long-term results of a National Institutes of Health (NIH) study published April 28 in the Archives of Internal Medicine. The largest and longest study of chronic kidney disease in African-Americans -- the African American Study of Kidney Disease and Hypertension (AASK) -- found that the disease substantially worsened in about one-fourth of participants, even with very good blood pressure control and use of kidney-protecting medications, currently the best available treatment. This subgroup of patients either lost half their kidney function or reached end-stage renal disease. "Despite these sobering results, blood pressure control is still vital in kidney disease and in many other diseases," said Elias A. Zerhouni, MD, Director, NIH, Bethesda, Maryland. "But this research clearly signals the importance of preventing kidney disease, of better understanding causes, and of finding better ways to manage it in the 26 million Americans who already have it." Good news also emerged from the study. About one-third of participants experienced a slow decline in kidney function, about what is generally observed with aging. "The factors that may be responsible for such a small loss of kidney function need to be studied," said Lawrence Y. Agodoa, MD, senior author of the study and Director, Kidney Failure Research, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, which funded the study. The AASK cohort study observed about 750 African Americans on recommended therapy for chronic kidney disease from 2002 to 2007. Study participants were initially recruited beginning in 1995 for the AASK clinical trial, which concluded in 2001 that angiotensin converting enzyme (ACE) inhibitor medication protected the kidneys better than 2 other classes of blood pressure drugs. During the cohort study, nearly 9 out of 10 participants were taking an ACE inhibitor or an angiotensin receptor blocker and average blood pressure was 133/78 mm Hg, close to national guidelines for high blood pressure in people with chronic kidney disease. Uncontrolled high blood pressure, an increase in the number of people with diabetes, and the aging of the US population means more people than ever are getting and living with kidney problems. About 13% of the US population, up from 10% in 1994, now have chronic kidney disease. And in 2005, more than 485,000 people were on chronic dialysis or had a kidney transplant for kidney failure, costing Medicare, private insurers, and patients US$32 billion. The AASK trial and cohort studies were conducted at 21 US medical centres and have been funded by NIDDK since 1994. Additional support was provided by the NIH National Center on Minority Health and Health Disparities and by King Pharmaceuticals. SOURCE: National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases
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