Hypertensive kidney disease in African Americans

End-stage renal disease is a significant public health problem in both deve loped and developing countries. The magnitude and pattern of renal disease varies between countries. This variability could probably be explained by t he racial and ethnic composition. The United States is a typical example, s howing significant racial and ethnic differences in the magnitude and patte rn of renal disease. African Americans, Native Americans and Pacific Island ers are disproportionately afflicted with end-stage kidney failure (ESRD), compared with Caucasians and Asians. Whereas diabetes mellitus, primarily t ype 2, is the predominant cause of renal disease (and ESRD) in the US, and prominently in Native Americans, hypertensive kidney disease is the most pr evalent cause of ESRD in African Americans. Some of the suggested reasons f or the increased incidence and prevalence of hypertensive kidney disease in African Americans include the higher prevalence and severity of hypertensi on, especially in the early years of life, lower socio-economic status lead ing to inadequate health care, a greater propensity towards developing intr insic renal vascular disease, a greater tendency towards developing target organ damage at 'normal' blood pressure levels, and the use of drugs that a re less renoprotective to treat their blood pressure.