BMJ 1997;314:209 (18 January)
Education and debate
Diabetes and hypertension in britain's ethnic minorities: implications for the future of renal services
Veena Soni Raleigh,
senior
research fellow aa National Institute of Epidemiology University of Surrey Guildford GU2 5YD
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.

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