Leading the way to a cure


Risk Factors for Health Disparities in SLE Nephritis

Hennis, Anselm, PhD

Chronic Disease Research Centre (Barbados)

Although the overall health status of Americans has improved, growing disparities in the health outcomes between African Americans and whites continue. This disparity is particularly evident among African Americans with lupus who experience much more aggressive disease and are five times more likely to die from related clinical complications than their white counterparts. 

Overall, black populations in the west have among the highest rates of lupus in the world, and African-American and Afro-Caribbean populations have up to eight times the rates reported in European descent populations. These high rates are likely related to the fact that people of African-origin brought to the west during the slave trade and now living in the United States, United Kingdom and the Caribbean originated from similar regions of West Africa and share a common heredity. 

Dr. Hennis and his team have already demonstrated a high rate of early progression to lupus nephritis in Barbadians similar to that reported in other westernized black populations, including African Americans. There is, however, little known about related risk factors. 

With the pilot grant, Dr. Hennis and his team plan to create a database and registry of all lupus patients in the island using standardized clinical protocols, and ascertain the completeness of registration of all known lupus patients on the island. They also plan to develop and pilot test a culturally appropriate environmental exposure questionnaire to evaluate risk factors for lupus and related renal disease. The team will also test procedures for the collection and transportation of biospecimens to collaborators at the University of Alabama for EBV transformation of cell lines, and to the Broad Institute for admixture studies. 

What this study means for people with lupus:  Understanding the modifiable and genetic factors behind the high rates of lupus kidney disease in blacks with lupus will help inform clinical and public health approaches to the disease in African-Americans and similar populations.

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