Scientists link blacks' genes to kidney failure

December 02, 1992|By Jonathan Bor | Jonathan Bor,Staff Writer

An article in yesterday's Sun should have said that scientists at the Johns Hopkins School of Medicine Hospital expected to find in a study performed there that poverty and other social factors were to blame for the higher incidence of kidney failure among blacks with diabetes. In their study, they were surprised to find, however, that an inherited predisposition is probably responsible for the higher rates.

The Sun regrets the error.

Scientists searching for clues to why diabetic blacks suffer disproportionately from potentially fatal kidney failure have suggested that a genetic factor rather than poverty or poor health care is chiefly to blame.

Dr. Frederick L. Brancati, an epidemiologist with the Johns Hopkins School of Medicine, said he expects to find that sociological factors would explain why black Americans with diabetes are more than three times as likely as whites to progress to end-stage kidney failure.


The end-stage disease is so serious a patient must go on dialysis or receive a kidney transplant to stay alive.

"The most straightforward explanation is that there's some biological difference," said Dr. Brancati, the lead author of an article appearing in today's Journal of the American Medical Association.

"I was surprised by this finding, and I'd personally need a lot more evidence to convince myself it's biological."

Dr. Brancati said the findings ran against the grain of his usual thinking about racial differences. "Different ethnic groups are a lot more alike than they are different," he said.

"The biggest differences would be environmental, cultural, behavioral and socioeconomic."

The Hopkins study was based entirely on statistics, and thus did not conclude anything about inherited factors that could predispose blacks to kidney failure.

Dr. Brancati said he hopes the study would spur scientists to look further into the mystery.

The Hopkins scientists combed through a registry of every case of end-stage kidney failure diagnosed in Maryland, limiting their study to 442 people identified between 1980 and 1985.

To their surprise, they found that black Americans suffering from adult-onset diabetes -- by far, the most common type of diabetes -- were four times as likely as whites to develop severe kidney failure even after scientists adjusted for social differences such as education, income and health care.

Adult-onset diabetes accounts for roughly 90 percent of all diabetic cases. It tends to surface in one's 50s, runs in families and is most common among obese people.

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