Risks for CKD in Asian Americans

In the United States, kidney disease occurs more frequently in racial and ethnic minority groups than in the general population. Asian Americans are twice as likely to develop kidney failure as Caucasian Americans.

Diabetes is often the culprit

Diabetes is the leading cause of kidney disease, representing about 43 percent of all new cases each year. Diabetes damages the blood vessels of the kidneys, sometimes to the point where the kidneys can no longer clean the blood. People with diabetes are the fastest-growing group of kidney dialysis patients and transplant recipients.

There are two types of diabetes. Type 1 is when the pancreas does not make insulin. It is typically diagnosed in young children. Type 2 is when the body is resistant to insulin. This used to occur mostly in adults; however, more children are being diagnosed with type 2 due to being overweight and not getting enough exercise.

It is difficult to say how many Asian Americans currently have type 2 diabetes. Research has shown that type 2 diabetes is a growing problem for this population group. Diabetes is the fifth leading cause of death for Asian Americans in the 45 to 64 age range.

Traditional ways were healthier

Asians who have immigrated to the US and adopted an American diet are at greater risk for diabetes. Studies have shown that the traditional plant- and fish-based Asian diet has been replaced with a diet higher in calories and fat, and lower in fiber. Research comparing Japanese who live in Japan to Japanese who live in Hawaii , showed that the Hawaiian Japanese had a higher rate of obesity and double the rate of type 2 diabetes.

Exercise — or the lack of it — is another factor in diabetes control. In the past, physical labor was a part of many Asians' everyday lifestyle. Today, most Asian Americans' daily activities require little or no physical exertion.

Lifestyle changes to reduce risk

Risk factors for diabetes are linked to both genetics and lifestyle. While our genes have already been decided, steps can be taken to live a healthier lifestyle.

A good place to start is to maintain a healthy weight. Being overweight is a significant risk factor for diabetes. In addition, where a person carries the extra weight on their body is important. Those who carry extra weight on their midsection or upper body area are at a higher risk of developing type 2 diabetes.

A study sponsored by the National Institutes of Health (NIH) found that diet and exercise could lower the risk of developing type 2 diabetes. One study group who did moderate exercise 30 minutes per day and ate a healthier diet were able to reduce their risk of getting type 2 diabetes by 58%.

Testing is key to early diagnosis and treatment

The National Kidney Foundation (NKF) has issued guidelines for those at high risk for chronic kidney disease. This group includes Asian Americans and Pacific Islanders. Also at risk are people with: diabetes, high blood pressure or a family history of high blood pressure, older Americans, African Americans, American Indians and Hispanic Americans.

Andrew Levey, Chief, Division of Nephrology of Tufts-New England Medical Center and chairman of the group who developed the guidelines, said, “We now realize that earlier stages of the disease are much more common than previously thought. If the diagnosis is made earlier and if kidney disease is treated earlier, some of the complications of chronic kidney disease can be prevented, including the progression to kidney failure and the development of heart disease.”

Those who fit into a high-risk group, should ask their doctor to perform these three tests:

1. A blood pressure check
2. An estimate of glomerular filtration rate (GFR), which measures kidney function
3. A dipstick test for protein in the urine

If test results show signs of kidney disease, the doctor will monitor the patient and, if needed, prescribe medication. The doctor may also give the patient a special diet to follow and recommend other lifestyle changes.

Make sure you get tested regularly by your physician and send this article to your friends and family members to remind them. This is an opportunity for Asian Americans to learn about the high risks of diabetes and CKD, so the trend can be reversed.

Asian American population statistics

• As of July 2001, the estimated number of Asian Americans was 12.5 million, or 4.4% of the total US population. This group is growing rapidly—more than three times the growth rate of the entire US population.

• As of July 2001, the estimated number of Americans who say they are native Hawaiian and other Pacific Islander numbered more than 935,000.

• The states with the largest number of Asian Americans are California with 4.2 million (the largest number), New York , Hawaii , Texas and New Jersey . Hawaii is home to the largest number of native Hawaiians and other Pacific Islanders.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.

Sources:

• Hooper LM, Bennett CE. The Asian and Pacific Islander population in the United States : March 1997 (update). In Current population reports: Population characteristics. 1998; Washington , DC : U.S. Department of Commerce.
• Centers for Disease Control and Prevention. Chronic diseases in minority populations: African-Americans, American Indians and Alaska Natives, Asians and Pacific Islanders, Hispanic Americans. 1994; Atlanta : Centers for Disease Control and Prevention.
• Fujimoto WY . Diabetes in Asian and Pacific Islander Americans. In National Diabetes Data Group, Diabetes in America 1995;(NIH Publication No. 95-1468, 2nd ed., pp. 661-681). Bethesda , MD : National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
• Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Annals of Internal Medicine. 1996;125(3):221-232.
• Huang B, Rodriguez BL, Burchfiel CM, Chyou P, Curb JD, Yano K. Acculturation and prevalence of diabetes among Japanese-American men in Hawaii. American Journal of Epidemiology. 1996;144(7):674-681.
• Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002;346:393-403.