South-Asian Type 2 Diabetic Patients Have Higher Incidence and Faster Progression of Renal Disease Compared With Dutch-European Diabetic Patients

Abstract

Surinamese South-Asian migrants, living in the Netherlands and aged >30 years, have a nearly 40-fold increased age-adjusted risk for end-stage diabetic nephropathy in comparison with their European Dutch counterparts (1). Several studies in the U.K. also showed a higher incidence of end-stage renal failure in South-Asian diabetic patients (2,3,4,5,6). There is no clear explanation for the increased risk in South-Asian migrants, who originally descend from the Indian subcontinent. An earlier study showed no familial predisposition for renal disease in South-Asian migrants (7). There is a discrepancy between the reported eight-times higher prevalence of diabetes (8) and the 40-fold higher risk of end-stage diabetic nephropathy (1) in this population. This discrepancy could be explained by either a higher incidence of nephropathy in the Asian diabetic patients and/or faster progression to end-stage renal failure. We performed a cohort study in South-Asian and Dutch-European type 2 diabetic patients to compare differences in the incidence of microalbuminuria and progression of renal failure between both ethnic groups. We used the registry of the outpatient diabetic clinic of the Haga Teaching Hospital during the period of 1994–1996. Ethnicity was by self-report. Migrants who originally descend from the Indian subcontinent were reported as South-Asian. Patients who were of Dutch descent were reported as European. We selected a cohort of 149 South Asian type 2 diabetic patients and matched them for sex and level of urinary albumin excretion …