End-stage renal disease in Indo-Asians in the North-West of England

A Trehan, J Winterbottom, B Lane, R Foley, M Venning, R Coward, A M Macleod, R Gokal

    Research output: Contribution to journalArticle

    18 Citations (Scopus)

    Abstract

    Background: The incidence of end-stage renal disease (ESRD) in England is increasing. There is a higher incidence of ESRD in British Indo-Asians than in the White population.

    Aim: To determine to what degree the increasing demand for renal replacement therapy in the UK is due to Indo-Asian patients. To study the presentation to renal services of Indo-Asian patients with ESRD and report any inequalities in initial treatment of Indo-Asian patients with ESRD compared to their White counterparts.

    Design: Prospective, inception cohort study.

    Methods: Consecutive adult patients with ESRD who started renal replacement therapy between 1 April 2000 and 31 December 2001 in all 14 renal units serving an area from North Cheshire to South Cumbria, including Greater Manchester and Lancashire, were recruited and interviewed.

    Results: Of the 578 patients, 9.5% were Indo-Asian. The annual acceptance rate for renal replacement therapy was 342 per million population in Indo-Asians, compared with 91 per million population in the White population (p<0.001). Indo-Asian patients with ESRD were younger (median age 51 years vs. 60 yrs, p=0.006) and more socially deprived (81% vs. 36.5% in the 5th Carstairs quintile, p<0.001). A greater proportion of Indo-Asian patients with ESRD presented late to specialist renal services (31% vs. 19%, p=0.03). Once adjusting for their younger age, atherosclerotic renovascular disease and/or hypertensive nephropathy was more prevalent in Indo-Asian patients (OR 4.9; p=0.03). There was no difference in the initial mode of maintenance dialysis or the perception of choice the patients felt they had, based on their ethnicity.

    Discussion: There is a silent epidemic of ESRD in Indo-Asian patients in the North-West, possibly vascular in aetiology, in which specialist intervention is late. This suggests that Indo-Asian patients should be prioritized for early intervention strategies to reduce the burden of ESRD.

    Original languageEnglish
    Pages (from-to)499-504
    Number of pages6
    JournalQJM
    Volume96
    Issue number7
    DOIs
    Publication statusPublished - 2003

    Keywords

    • replacement therapy
    • failure
    • need
    • nephropathy
    • registry
    • UK

    Cite this

    Trehan, A., Winterbottom, J., Lane, B., Foley, R., Venning, M., Coward, R., ... Gokal, R. (2003). End-stage renal disease in Indo-Asians in the North-West of England. QJM, 96(7), 499-504. https://doi.org/10.1093/qjmed/hcg088

    End-stage renal disease in Indo-Asians in the North-West of England. / Trehan, A ; Winterbottom, J ; Lane, B ; Foley, R ; Venning, M ; Coward, R ; Macleod, A M ; Gokal, R .

    In: QJM, Vol. 96, No. 7, 2003, p. 499-504.

    Research output: Contribution to journalArticle

    Trehan, A, Winterbottom, J, Lane, B, Foley, R, Venning, M, Coward, R, Macleod, AM & Gokal, R 2003, 'End-stage renal disease in Indo-Asians in the North-West of England', QJM, vol. 96, no. 7, pp. 499-504. https://doi.org/10.1093/qjmed/hcg088
    Trehan A, Winterbottom J, Lane B, Foley R, Venning M, Coward R et al. End-stage renal disease in Indo-Asians in the North-West of England. QJM. 2003;96(7):499-504. https://doi.org/10.1093/qjmed/hcg088
    Trehan, A ; Winterbottom, J ; Lane, B ; Foley, R ; Venning, M ; Coward, R ; Macleod, A M ; Gokal, R . / End-stage renal disease in Indo-Asians in the North-West of England. In: QJM. 2003 ; Vol. 96, No. 7. pp. 499-504.
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    abstract = "Background: The incidence of end-stage renal disease (ESRD) in England is increasing. There is a higher incidence of ESRD in British Indo-Asians than in the White population.Aim: To determine to what degree the increasing demand for renal replacement therapy in the UK is due to Indo-Asian patients. To study the presentation to renal services of Indo-Asian patients with ESRD and report any inequalities in initial treatment of Indo-Asian patients with ESRD compared to their White counterparts.Design: Prospective, inception cohort study.Methods: Consecutive adult patients with ESRD who started renal replacement therapy between 1 April 2000 and 31 December 2001 in all 14 renal units serving an area from North Cheshire to South Cumbria, including Greater Manchester and Lancashire, were recruited and interviewed.Results: Of the 578 patients, 9.5{\%} were Indo-Asian. The annual acceptance rate for renal replacement therapy was 342 per million population in Indo-Asians, compared with 91 per million population in the White population (p<0.001). Indo-Asian patients with ESRD were younger (median age 51 years vs. 60 yrs, p=0.006) and more socially deprived (81{\%} vs. 36.5{\%} in the 5th Carstairs quintile, p<0.001). A greater proportion of Indo-Asian patients with ESRD presented late to specialist renal services (31{\%} vs. 19{\%}, p=0.03). Once adjusting for their younger age, atherosclerotic renovascular disease and/or hypertensive nephropathy was more prevalent in Indo-Asian patients (OR 4.9; p=0.03). There was no difference in the initial mode of maintenance dialysis or the perception of choice the patients felt they had, based on their ethnicity.Discussion: There is a silent epidemic of ESRD in Indo-Asian patients in the North-West, possibly vascular in aetiology, in which specialist intervention is late. This suggests that Indo-Asian patients should be prioritized for early intervention strategies to reduce the burden of ESRD.",
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    AU - Trehan, A

    AU - Winterbottom, J

    AU - Lane, B

    AU - Foley, R

    AU - Venning, M

    AU - Coward, R

    AU - Macleod, A M

    AU - Gokal, R

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    N2 - Background: The incidence of end-stage renal disease (ESRD) in England is increasing. There is a higher incidence of ESRD in British Indo-Asians than in the White population.Aim: To determine to what degree the increasing demand for renal replacement therapy in the UK is due to Indo-Asian patients. To study the presentation to renal services of Indo-Asian patients with ESRD and report any inequalities in initial treatment of Indo-Asian patients with ESRD compared to their White counterparts.Design: Prospective, inception cohort study.Methods: Consecutive adult patients with ESRD who started renal replacement therapy between 1 April 2000 and 31 December 2001 in all 14 renal units serving an area from North Cheshire to South Cumbria, including Greater Manchester and Lancashire, were recruited and interviewed.Results: Of the 578 patients, 9.5% were Indo-Asian. The annual acceptance rate for renal replacement therapy was 342 per million population in Indo-Asians, compared with 91 per million population in the White population (p<0.001). Indo-Asian patients with ESRD were younger (median age 51 years vs. 60 yrs, p=0.006) and more socially deprived (81% vs. 36.5% in the 5th Carstairs quintile, p<0.001). A greater proportion of Indo-Asian patients with ESRD presented late to specialist renal services (31% vs. 19%, p=0.03). Once adjusting for their younger age, atherosclerotic renovascular disease and/or hypertensive nephropathy was more prevalent in Indo-Asian patients (OR 4.9; p=0.03). There was no difference in the initial mode of maintenance dialysis or the perception of choice the patients felt they had, based on their ethnicity.Discussion: There is a silent epidemic of ESRD in Indo-Asian patients in the North-West, possibly vascular in aetiology, in which specialist intervention is late. This suggests that Indo-Asian patients should be prioritized for early intervention strategies to reduce the burden of ESRD.

    AB - Background: The incidence of end-stage renal disease (ESRD) in England is increasing. There is a higher incidence of ESRD in British Indo-Asians than in the White population.Aim: To determine to what degree the increasing demand for renal replacement therapy in the UK is due to Indo-Asian patients. To study the presentation to renal services of Indo-Asian patients with ESRD and report any inequalities in initial treatment of Indo-Asian patients with ESRD compared to their White counterparts.Design: Prospective, inception cohort study.Methods: Consecutive adult patients with ESRD who started renal replacement therapy between 1 April 2000 and 31 December 2001 in all 14 renal units serving an area from North Cheshire to South Cumbria, including Greater Manchester and Lancashire, were recruited and interviewed.Results: Of the 578 patients, 9.5% were Indo-Asian. The annual acceptance rate for renal replacement therapy was 342 per million population in Indo-Asians, compared with 91 per million population in the White population (p<0.001). Indo-Asian patients with ESRD were younger (median age 51 years vs. 60 yrs, p=0.006) and more socially deprived (81% vs. 36.5% in the 5th Carstairs quintile, p<0.001). A greater proportion of Indo-Asian patients with ESRD presented late to specialist renal services (31% vs. 19%, p=0.03). Once adjusting for their younger age, atherosclerotic renovascular disease and/or hypertensive nephropathy was more prevalent in Indo-Asian patients (OR 4.9; p=0.03). There was no difference in the initial mode of maintenance dialysis or the perception of choice the patients felt they had, based on their ethnicity.Discussion: There is a silent epidemic of ESRD in Indo-Asian patients in the North-West, possibly vascular in aetiology, in which specialist intervention is late. This suggests that Indo-Asian patients should be prioritized for early intervention strategies to reduce the burden of ESRD.

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    KW - failure

    KW - need

    KW - nephropathy

    KW - registry

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    JO - QJM

    JF - QJM

    SN - 1460-2725

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