• Pugh, Jacqueline A (PI)

Project: Research project

Project Details


The risk of development of end-stage renal disease (ESRD) secondary
to non-insulin-dependent diabetes (NIDDM) has not yet been well
defined despite the fact that approximately ninety percent of
diabetics in the U.S. are of the NIDDM type. Data from our group
reveal an approximate 6.5 fold excess in the incidence of diabetes-
related ESRD in Mexican Americans (MAs) over non-Hispanic whites
(NHWs). The age distribution of these cases suggest that the
excess may be due to a predominance of NIDDM-related ESRD in MAs.
However, the data base used for these analyses did not distinguish
between NIDDM-related and insulin dependent (IDDM)-related ESRD. We propose to carry out an epidemiologic study of diabetes-related
ESRD. A surveillance study will define the incidence of treatment
of diabetes-related ESRD in MAs and NHWs secondary to NIDDM and
IDDM and ethnic differences in the severity of diabetes-related
ESRD at onset of treatment (dialysis or transplantation). Using a population-based design, all cases of diabetes-related ESRD
in a 32 county area o( south-central Texas will be identified over
a 56 month period. A one-half random sample of MA cases and all
NHW and black cases will be reviewed for a total 345 cases.
Another 360 cases of non-diabetes-related ESRD will also be
abstracted to assess misclassification. Relevant clinical data
will be obtained through chart review and patient interview
allowing classification of NIDDM vs. IDDM cases as well as
diabetes-related vs. non-diabetes-related ESRD. ln a concurrent case-control study, risk factors for the
development of ESRD in patients with NIDDM will be investigated.
Potential risk factors to be explored include age at onset of
diabetes, co-morbid conditions such as hypertension and urinary
tract infections, type of treatment of diabetes, and level of
hyperglycemia prior to development of ESRD. In this phase 250
NIDDM-related ESRD cases and 250 NIDDM controls without ESRD will
be studied. The NIDDM controls will be identified from the San
Antonio Heart Study, a population-based diabetes and cardiovascular
risk factor survey. Both retrospective chart reviews and subject
interviews will be performed.
Effective start/end date9/1/888/31/94


  • National Institutes of Health: $163,978.00


  • Medicine(all)


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