HIV-positive African Americans are more likely than positive white people to develop end-stage renal disease (ESRD) requiring dialysis or a transplant. The presumed cause: Positive African Americans are more likely to have chronic kidney disease (CKD) in the first place. Now, Johns Hopkins University researchers offer another theory: CKD may turn into ESRD faster in African Americans.

Medical records of 4,259 positive people (3,332 African American, 927 white) were analyzed. After about four and a half years, 284 had developed CKD, 100 of whom had progressed to ESRD. African-American people generally had more serious forms of kidney disease than white people, and their kidney-function blood measures deteriorated more quickly. Silverish lining: As new meds for both HIV and kidney disease became available over the review period, rates of chronic kidney disease fell—and kidney-disease progression slowed.