Diabetic Renal Disease in Blacks — Inevitable or Preventable?

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Abstract
During the past decade, the increased acceptance of diabetic and older patients to receive renal replacement therapy has caused diabetes mellitus to be recognized as one of the leading causes of end-stage renal disease in the United States. Diabetes now accounts for approximately 25 percent of all patients with end-stage renal disease. In this issue of the Journal, Cowie et al.1 document this trend and also show an excess of end-stage renal disease among diabetic blacks that cannot be explained by age or by racial differences in the prevalence of diabetes. What, then, accounts for this excess rate of . . .