Approximately ten percent of U.S. adults have a family history of end-stage renal disease (ESRD), and these individuals appear to be at increased risk of developing kidney disease themselves.
"A family history of kidney disease is more frequent in African-Americans, who are also at substantially higher risk of ESRD," comments Dr. William McClellan of Emory University in Atlanta, lead author of the new study. "Our results suggest that efforts to reduce the risk of progressive kidney disease and ESRD targeted at these families might help improve the detection, treatment, and control of early kidney disease."
Dr. McClellan and colleagues used data on a representative sample of more than 12,000 black and white Americans aged 45 or older. Subjects were asked whether they had any relatives with "kidney failure," that is, ESRD: irreversible loss of kidney function requiring dialysis or transplantation.
Overall, 9.5 percent of subjects reported ESRD in a first-degree relative—a parent, sibling, or child. A family history of ESRD was more than twice as common for African-Americans as whites: 14 percent versus 6.4 percent. Having a family history of ESRD was also linked to higher rates of other kidney disease risk factors, including high blood glucose (sugar) levels and especially obesity.
African-Americans who had a relative with ESRD were at increased risk of having reduced kidney function themselves. The levels of impairment were similar to those leading to the diagnosis of chronic kidney disease (CKD)—initially mild reductions in kidney function that can lead to ESRD. (The relationship between family history and personal risk of kidney disease was not as strong in whites.)
End-stage renal disease is an increasingly frequent problem, occurring at substantially higher rates among African-Americans than whites. Previous studies have found that 1 in 5 patients starting dialysis report that other members of their family also haves ESRD. The new study sought to estimate the percentage of Americans having a family history of ESRD, and to determine the risk of kidney disease risk for these individuals.
"The results add an important new piece of evidence that family members of ESRD patients are at high risk for early kidney disease," says Dr. McClellan. If confirmed by further research, the findings might lead to new approaches to identification and treatment of families at high risk of kidney disease. Dr. McClellan adds, "For example, when an ESRD patient starts dialysis, we might consider contacting family members to see if they could benefit from interventions to prevent or reduce the risk of kidney disease."
The study entitled, "Prevalence and Characteristics of a Family History of End-Stage Renal Disease (ESRD) Among Adults in the United States Population: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Renal Cohort Study," will be in the April issue of the Journal of the American Society of Nephrology.
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