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Clin J Am Soc Nephrol. 2011 Aug;6(8):1858-65. doi: 10.2215/CJN.00500111. Epub 2011 Jul 22.

Racial and ethnic differences in mortality among individuals with chronic kidney disease: results from the Kidney Early Evaluation Program (KEEP).

Author information

  • 1Cleveland Clinic Medicine Institute, 9500 Euclid Avenue/G10, Cleveland, Ohio 44195, USA. jollys@ccf.org

Abstract

BACKGROUND AND OBJECTIVES:

Chronic kidney disease (CKD) is prevalent in minority populations and racial/ethnic differences in survival are incompletely understood.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

Secondary analysis of Kidney Early Evaluation Program participants from 2000 through 2008 with CKD, not on dialysis, and without previous kidney transplant was performed. Self-reported race/ethnicity was categorized into five groups: non-Hispanic white, African American, Asian, American Indian/Alaska Native, and Hispanic. CKD was defined as a urinary albumin to creatinine ratio of ≥30 mg/g among participants with an estimated GFR (eGFR) ≥60 ml/min per 1.73 m(2) or an eGFR of <60 ml/min per 1.73 m(2). The outcome was all-cause mortality. Covariates used were age, sex, obesity, diabetes, hypertension, albuminuria, baseline eGFR, heart attack, stroke, smoking, family history, education, health insurance, geographic region, and year screened.

RESULTS:

19,205 participants had prevalent CKD; 55% (n = 10,560) were White, 27% (n = 5237) were African American, 9% (n = 1638) were Hispanic, 5% (n = 951) were Asian, and 4% (n = 813) were American Indian/Alaska Native. There were 1043 deaths (5.4%). African Americans had a similar risk of death compared with Whites (adjusted Hazard Ratio (AHR) 1.07, 95% CI 0.90 to 1.27). Hispanics (AHR 0.66, 95% CI 0.50 to 0.94) and Asians (AHR 0.63, 95% CI 0.41 to 0.97) had a lower mortality risk compared with Whites. In contrast, American Indians/Alaska Natives had a higher risk of death compared with Whites (AHR 1.41, 95% CI 1.08 to 1.84).

CONCLUSIONS:

Significant differences in mortality among some minority groups were found among persons with CKD detected by community-based screening.

PMID:
21784835
[PubMed - indexed for MEDLINE]
PMCID:
PMC3156424
Free PMC Article

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