ABSTRACT
The greatest incidence and prevalence of end-stage renal disease (ESRD) are reported in the United States and Japan with incidence rates in excess of 300 cases per million population. The incidence of hypertensive ESRD is very high among younger African Americans, nearly 20 times the incidence of Caucasians in the 20-to 44-year-old group. Treatment is non-uniform; in instances where the causative agent is known, removal from exposure may diminish the rate of progression. ESRD is inevitable when patients are discovered at the stage 4 of the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative. The prescribed dose, and hence the delivered dose of dialysis is more likely to be sub-optimal in African-American hemodialysis patients despite clear guidelines for hemodialysis dose and frequent monitoring. Two diseases, namely diabetes mellitus and hypertension cause approximately 70% of all new adult ESRD cases in the United States.
