Publication:
Impact of age, race and ethnicity on dialysis patient survival and kidney transplantation disparities

2
0

Issued Date

2014

Resource Type

Article

File Type

application/pdf

ISSN

2508095

DOI

10.1159/000358497

Other identifier(s)

2-s2.0-84895585869

Rights Holder(s)

Scopus

Bibliographic Citation

American Journal of Nephrology. Vol 39, No.3 (2014), p.183-194

Suggested Citation

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. Impact of age, race and ethnicity on dialysis patient survival and kidney transplantation disparities. American Journal of Nephrology. Vol 39, No.3 (2014), p.183-194. doi:10.1159/000358497 Retrieved from: https://hdl.handle.net/20.500.14740/6459

Title

Impact of age, race and ethnicity on dialysis patient survival and kidney transplantation disparities

Author(s)

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.

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.

Subject(s)

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

View online Resources

Research Projects

Organizational Units

Journal Issue

URI

https://hdl.handle.net/20.500.14740/6459

Collections

Scopus: Year 1983-2021

Endorsement

Review

Supplemented By

Referenced By