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https://ir.swu.ac.th/jspui/handle/123456789/13929
Title: | Impact of age, race and ethnicity on dialysis patient survival and kidney transplantation disparities |
Authors: | Rhee C.M. Lertdumrongluk P. Streja E. Park J. Moradi H. Lau W.L. Norris K.C. Nissenson A.R. Amin A.N. Kovesdy C.P. Kalantar-Zadeh K. |
Keywords: | adult African American age aged article Caucasian comorbidity demography ethnicity female follow up groups by age hemodialysis patient Hispanic human kidney transplantation major clinical study male mortality priority journal race risk reduction survival access to information adolescent age ethnic group ethnology inflammation kidney transplantation middle aged procedures proportional hazards model Renal Insufficiency treatment outcome United States very elderly young adult Article controlled study kidney donor living donor malnutrition sensitivity analysis Access to Information Adolescent Adult African Americans Age Factors Aged Aged, 80 and over Ethnic Groups Female Hispanic Americans Humans Inflammation Kidney Transplantation Male Middle Aged Proportional Hazards Models Renal Insufficiency Treatment Outcome United States Young Adult |
Issue Date: | 2014 |
Abstract: | Background: Prior studies show that African-American and Hispanic dialysis patients have lower mortality risk than whites. Recent age-stratified analyses suggest this survival advantage may be limited to younger age groups, but did not concurrently compare Hispanic, African-American, and white patients, nor account for differences in nutritional and inflammatory status as potential confounders. Minorities experience inequities in kidney transplantation access, but it is unknown whether these racial/ethnic disparities differ across age groups. Methods: The associations between race/ethnicity with all-cause mortality and kidney transplantation were separately examined among 130,909 adult dialysis patients from a large national dialysis organization (entry period 2001-2006, follow-up through 2009) within 7 age categories using Cox proportional hazard models adjusted for case-mix and malnutrition and inflammatory surrogates. Results: African-Americans had similar mortality versus whites in younger age groups (18-40 years), but decreased mortality in older age groups (>40 years). In contrast, Hispanics had lower mortality versus whites across all ages. In sensitivity analyses using competing risk regression to account for differential kidney transplantation rates across racial/ethnic groups, the African-American survival advantage was limited to >60-years age categories. African-Americans and Hispanics were less likely to undergo kidney transplantation from all donor types versus whites across all ages, and these disparities were even more pronounced for living donor kidney transplantation (LDKT). Conclusions: Hispanic dialysis patients have greater survival versus whites across all ages; in African-Americans, this survival advantage is limited to patients >40 years of age. Minorities are less likely to undergo kidney transplantation, particularly LDKT, across all ages. © 2014 S. Karger AG, Basel. |
URI: | https://ir.swu.ac.th/jspui/handle/123456789/13929 https://www.scopus.com/inward/record.uri?eid=2-s2.0-84895585869&doi=10.1159%2f000358497&partnerID=40&md5=cc48ef84426a8efd285fe1542e11c4bc |
ISSN: | 2508095 |
Appears in Collections: | Scopus 1983-2021 |
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