African-Caribbean ethnicity is an independent predictor of significant decline in kidney function in people with type 1 diabetes

   Objective: The aim of the study was to identify the demographic and clinical features in an urban cohort of people with type 1 diabetes who developed ≥50% decline in estimated glomerular filtration rate (eGFR).  Research design and methods: We evaluated 5261 people with type 1 diabetes (51% female, 13.4% African-Caribbean) with baseline eGFR >45ml/min/1.73m2. Primary endpoint was an eGFR decline ≥50% from baseline with a final eGFR Results: Of the cohort 263 (5%) reached the primary endpoint. People who reached primary endpoint were more likely to be of African-Caribbean ethnicity, older, with a longer duration of diabetes, higher systolic blood pressure and HbA1c, more prevalent retinopathy, and higher albuminuria categories (p Conclusion: We report a novel observation that African-Caribbean ethnicity increased the risk of kidney function loss, an effect which was independent of traditional risk factors. Further studies are needed to examine the associated pathophysiology that may explain this observation. </p