Who is at risk for kidney failure related to high blood pressure?

Everyone has some risk of developing kidney failure from high blood pressure. African Americans, however, are more likely than Caucasians to have high blood pressure and its related kidney problems—even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure.2
People with diabetes also have a greater risk of developing kidney failure. Early management of high blood pressure is especially important for African Americans with diabetes.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), also part of the NIH, sponsored the African American Study of Kidney Disease and Hypertension (AASK) to find effective ways to prevent high blood pressure and kidney failure in this population. The results, published in the November 20, 2002, issue of the Journal of the American Medical Association, showed that an ACE inhibitor was the most effective drug at slowing the progression of kidney disease in African Americans. While ACE inhibitors help reduce the risk of kidney disease, they are less effective in lowering blood pressure in African Americans than in Caucasians.

2United States Renal Data System. USRDS 2007 Annual Data Report. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services; 2007.

http://kidney.niddk.nih.gov/kudiseases/pubs/highblood/#risk