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Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study

Background: Observational studies from the United States have identified black race as conferring a survival advantage on dialysis. This study represents the first large single-center study from a UK dialysis unit examining the outcome of ethnic minorities on renal replacement therapy (RRT). Methods...

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Autores principales: Cole, Nicholas, Bedford, Michael, Cai, Andrew, Jones, Chris, Cairns, Hugh, Jayawardene, Satish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dustri-Verlag Dr. Karl Feistle 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928033/
https://www.ncbi.nlm.nih.gov/pubmed/24985953
http://dx.doi.org/10.5414/CN108247
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author Cole, Nicholas
Bedford, Michael
Cai, Andrew
Jones, Chris
Cairns, Hugh
Jayawardene, Satish
author_facet Cole, Nicholas
Bedford, Michael
Cai, Andrew
Jones, Chris
Cairns, Hugh
Jayawardene, Satish
author_sort Cole, Nicholas
collection PubMed
description Background: Observational studies from the United States have identified black race as conferring a survival advantage on dialysis. This study represents the first large single-center study from a UK dialysis unit examining the outcome of ethnic minorities on renal replacement therapy (RRT). Methods: A retrospective analysis of all patients of white or black race initiating RRT at King’s College Hospital Renal Unit, London, between 1996 and 2008 was performed. A total of 1,340 patients were studied, of which 952 (71%) were of white race, and 388 (29%) were of black race. Kaplan-Meier survival curves, the log rank test and Cox’s proportional hazard models were used to compare survival between groups. Results: The results revealed black ethnicity to be associated with a significant survival benefit on dialysis. This was the case even after adjustment for age, gender, diabetes, transplantation, and deprivation. In those patients not transplanted, black race conferred a hazard ratio (HR) of 0.51 (95% CI 0.41 – 0.63) over 5 years. Conclusions: This study provides evidence for a lower mortality rate amongst black patients on dialysis in comparison with their white counterparts in the UK. The reasons behind this remain poorly understood but a lower incidence of cardiovascular disease in black patients and more kidney-limited disease may be important.
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spelling pubmed-49280332016-07-14 Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study Cole, Nicholas Bedford, Michael Cai, Andrew Jones, Chris Cairns, Hugh Jayawardene, Satish Clin Nephrol Research Article Background: Observational studies from the United States have identified black race as conferring a survival advantage on dialysis. This study represents the first large single-center study from a UK dialysis unit examining the outcome of ethnic minorities on renal replacement therapy (RRT). Methods: A retrospective analysis of all patients of white or black race initiating RRT at King’s College Hospital Renal Unit, London, between 1996 and 2008 was performed. A total of 1,340 patients were studied, of which 952 (71%) were of white race, and 388 (29%) were of black race. Kaplan-Meier survival curves, the log rank test and Cox’s proportional hazard models were used to compare survival between groups. Results: The results revealed black ethnicity to be associated with a significant survival benefit on dialysis. This was the case even after adjustment for age, gender, diabetes, transplantation, and deprivation. In those patients not transplanted, black race conferred a hazard ratio (HR) of 0.51 (95% CI 0.41 – 0.63) over 5 years. Conclusions: This study provides evidence for a lower mortality rate amongst black patients on dialysis in comparison with their white counterparts in the UK. The reasons behind this remain poorly understood but a lower incidence of cardiovascular disease in black patients and more kidney-limited disease may be important. Dustri-Verlag Dr. Karl Feistle 2014-08 2014-07-02 /pmc/articles/PMC4928033/ /pubmed/24985953 http://dx.doi.org/10.5414/CN108247 Text en © Dustri-Verlag Dr. K. Feistle http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cole, Nicholas
Bedford, Michael
Cai, Andrew
Jones, Chris
Cairns, Hugh
Jayawardene, Satish
Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title_full Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title_fullStr Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title_full_unstemmed Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title_short Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study
title_sort black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a uk study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928033/
https://www.ncbi.nlm.nih.gov/pubmed/24985953
http://dx.doi.org/10.5414/CN108247
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