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Macaulay A. C. Onuigbo, MD, MSc, FWACP

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

My colleagues and I read with a heightened level of interest, some disappointment, and a sense of foreboding and erudite concern, the recent report of significant doubling of serum creatinine level and end-stage renal disease (ESRD) among African Americans in the African American Study of Kidney Disease and Hypertension (AASK) cohort study, who received renin-angiotensin-aldosterone system (RAAS)-blocking therapy and were targeted for blood pressure reduction.¹ Over 7 years, 569 of 1094 African American patients experienced the primary composite outcome of doubling of serum creatinine level, ESRD, or death—a 10-year cumulative incidence of 54%.¹ Only 34% experienced a slow decline of kidney function.¹ Of 164 patients with a doubling of serum creatinine level, 134 (81.7%) subsequently developed ESRD.¹ Despite these very troubling trends, the authors argued that the rate of chronic kidney disease (CKD) progression would likely have been even greater without RAAS-blocking therapy.¹ . . . [Full Text of this Article]

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