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Mark E. Molitch, MD
JAMA. 1990;263(19):2639-2640. doi:10.1001/jama.1990.03440190095049.
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Diabetes mellitus continues to be a major public health problem that affects about 12 million Americans. Interesting new observations have been made regarding the development and progression of some complications of diabetes mellitus, especially nephropathy.

About 25% of patients in dialysis units have diabetic nephropathy, which eventually affects about one third of those with insulin-dependent diabetes and 5% to 10% of those with non—insulin-dependent diabetes.1 Certain factors may be important in predicting who may develop end-stage renal disease. Blacks, compared with whites, have an increased risk of developing end-stage renal disease that is 1.62 times greater for insulin-dependent diabetes and 3.93 times greater for non—insulin-dependent diabetes, possibly partly related to higher blood pressures in blacks.2 A history of nephropathy in a diabetic sibling puts a person with insulin-dependent diabetes at considerably increased risk for developing nephropathy.3 Having a parent with hypertension results in a threefold increased risk


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