Regional variation in end-stage renal disease.

Regional variations in end-stage renal disease have been found within a country, even within a race. Since diabetic nephropathy is the leading cause of end-stage renal disease in developed countries, first of all, regional differences in diabetic nephropathy must be considered. Although the incidence of end-stage renal disease due to diabetic nephropathy has been found to differ among different areas within a country, there are no data on regional variations in the incidence of type II diabetes or diabetic nephropathy without renal failure. Such regional variations could hardly be explained by local differences in gene pools alone, which suggests an important role of environmental factors. It is not clear at present how regional variations in the incidence of end-stage renal disease are generated. If we can identify the factors that contribute to the regional differences, we can take these into account in future treatment strategies for renal disease. Thus, much effort is required in further analysis of regional differences in end-stage renal disease dynamics.