Diabetes and hypertension in britain's ethnic minorities: implications for the future of renal services

Abstract

Diabetes and hypertension are much more prevalent among Britain's 2.5 million Asian and African-Caribbean population than among the white population and are major contributors to end stage renal failure. Asians and African-Caribbeans have threefold to fourfold higher acceptance rates on to renal replacement therapy than white people, and in some districts they comprise up to half of all patients receiving such treatment. Their greater need for renal replacement treatment is accompanied by difficulties of tissue matching in cross racial transplants and a shortage of donor organs. The aging of ethnic minority populations will increase local need for renal services significantly. Measures to control diabetes, hypertension, and secondary complications in Asian and African-Caribbean communities will contribute both to safeguarding health and to economies in spending on renal services. Education about diabetes and hypertension, modification of behavioural risk factors, early diagnosis, effective glycaemic and blood pressure control, and early referral for signs of renal impairment are essential preventive measures. Primary and community health care professionals have a critical role to play here.

Ethnicity, Socioeconomic Status, and Attainment of Clinical Practice Guideline Standards in Dialysis Patients in the United Kingdom

“…For patients with missing ethnicity data on the UKRR database, ethnicity was updated in a hierarchical order: from the UK Transplant database, the independent organization responsible for maintaining the national organ donor register in the UK, using the name-recognition software program SANGRA, developed and validated in the UK to identify South Asian ethnic origin by name (20); and finally by recoding patients with missing ethnicity as Whites if they lived in a UK Census 2001 ward that had a predominant White population (Ͼ98%). The incidence of RRT is three to four times higher in ethnic minorities compared with Whites in the UK (21,22), and therefore updating ethnicity using Census statistics could potentially lead to a misclassification error of up to 6% to 8%, which was considered acceptable. Patients whose ethnicity could not be updated by the above methods and those with missing primary renal disease and residence postcode were excluded from the study.…”

‘Under pressure’: how Ghanaian, African-Surinamese and Dutch patients explain hypertension

“…In the Western hemisphere, hypertension is more prevalent and its complications are more severe among people of African descent than it is among populations of European descent. [1][2][3][4] As do other European countries, the Netherlands has a growing immigrant population of African descent, particularly in urban areas. African-Surinamese (hereafter, Surinamese) immigrants from the former Dutch colony of Suriname and Ghanaians from West Africa comprise two major categories of these immigrants.…”

Attitudes to organ donation among South Asians in an English high street

“…Of the 7 people who were not sure whether their religion allowed organ donation and transplantation, 6 were Muslim. 'Other' reasons included 'not really thought about it' or 'not bothered doing it'.…”