Publication Spotlight: Dr. Burrows

Read the below interview with Nilka Rios Burrows, MPH, MT (ASCP), CKD Initiative Acting Team Lead, CDC Division of Diabetes Translation and author of Sustained Lower Incidence of Diabetes-Related End-Stage Kidney Disease Among American Indians and Alaska Natives, Blacks, and Hispanics in the U.S., 2000-2016.

What question did your study aim to answer?

From 1996 to 2013, the incidence of diabetes-related end-stage kidney disease (ESKD-D) among American Indian and Alaska Native (AIAN) and Black adults declined. In light of the leveling off in ESKD-D incidence in the US diabetic population since 2010 and the significant decline in diagnosed diabetes prevalence among AIANs, we explored whether recent trends in ESKD-D incidence by race or ethnicity had changed.

What inspired you to conduct this study?

We first published the remarkable decline in ESKD-D incidence among AIANs in the CDC’s Vital Signs in January 2017. We wanted to update this report with more years of data to assess whether ESKD-D incidence in AIANs had continued to decline.

Which USRDS datasets did you use to conduct your study?

Patient Core dataset.

Using plain language, please summarize your study conclusions in two or three points.

• From 2000 to 2016, the rate of new cases of kidney failure from diabetes declined significantly for AIAN (-53%), Hispanic (-33%), and Black adults (-20%); for White adults, however, the rate increased by 10%.
• Despite these significant declines, kidney failure from diabetes for AIAN, Hispanic, and Black adults in 2016 remained nearly twice as high or higher than for White adults. Continued efforts in diabetes and kidney disease management are very important to sustain the declining trend in these populations.
• The significant reduction (-53%) in kidney failure from diabetes among AIAN adults parallels sustained improvements in glycemic, lipid, and blood pressure control for AIANs and likely resulted from improvements in patient care and services funded by the Special Diabetes Program for Indians.

Please share a specific insight about working with USRDS data that you learned during the completion of this study. (No detail is too small.)

USRDS data and the publication findings were instrumental in documenting improved outcomes among AIANs with diabetes and in reauthorizing Congressional funding for the Special Diabetes Program for Indians. The Indian Health Service experience serves as a model for diabetes management in other healthcare systems, especially those serving populations at high risk for diabetes complications and as inspiration to replicate their success and impact on kidney disease outcomes.