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Cited by 139Chronic Kidney Disease and DiabetesDialysis and Renal Disease ManagementHealth disparities and outcomes

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White/black racial differences in risk of end-stage renal disease and death.

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Choi, Andy I., Rodriguez, Rudolph A., Bacchetti, Peter, Bertenthal, Daniel, Hernandez, German T., O'Hare, Ann M.·2009·The American Journal of Medicine
DOI 10.1016/j.amjmed.2008.11.021PMC PMC2749005
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Abstract

Background End-stage renal disease disproportionately affects black persons, but it is unknown when in the course of chronic kidney disease racial differences arise. Understanding the natural history of racial differences in kidney disease may help guide efforts to reduce disparities.Methods We compared white/black differences in the risk of end-stage renal disease and death by level of estimated glomerular filtration rate (eGFR) at baseline in a national sample of 2,015,891 veterans between 2001 and 2005.Results Rates of end-stage renal disease among black patients exceeded those among white patients at all levels of baseline eGFR. The adjusted hazard ratios for end-stage renal disease associated with black versus white race for patients with an eGFR > or = 90, 60-89, 45-59, 30-44, 15-29, and <15 mL/min/1.73 m2, respectively, were 2.14 (95% confidence interval [CI], 1.72-2.65), 2.30 (95% CI, 2.02-2.61), 3.08 (95% CI, 2.74-3.46), 2.47 (95% CI, 2.26-2.70), 1.86 (95% CI, 1.75-1.98), and 1.23 (95% CI, 1.12-1.34). We observed a similar pattern for mortality, with equal or higher rates of death among black persons at all levels of eGFR. The highest risk of mortality associated with black race also was observed among those with an eGFR 45-59 mL/min/1.73 m2 (hazard ratio 1.32, 95% CI, 1.27-1.36).Conclusion Racial differences in the risk of end-stage renal disease appear early in the course of kidney disease and are not explained by a survival advantage among blacks. Efforts to identify and slow progression of chronic kidney disease at earlier stages may be needed to reduce racial disparities.

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  1. Powe, 2008, Let's get serious about racial and ethnic disparities, J Am Soc Nephrol, 19, 1271, 10.1681/asn.2008040358 · DOI

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Metadata

Authors
Choi, A. I., Rodriguez, R. A., Bacchetti, P., Bertenthal, D., Hernandez, G. T., & O'Hare, A. M.
Affiliations
  • San Francisco VA Medical Center (US)
  • University of Washington (US)
  • University of California, San Francisco (US)
Corresponding author
Choi, Andy I.
ORCID
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2009-07
Volume
122
Issue
7
Pages
672-678
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/j.amjmed.2008.11.021
PMC
PMC2749005
OpenAlex
W2016341825
Semantic Scholar
5876ab6c363fefbd64a516011fa8183a0d9fcbea
Cited by
139
References
38
Citations by year
2026: 5 · 2025: 8 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 10 · 2020: 10 · 2019: 9 · 2018: 12 · 2017: 7 · 2016: 5 · 2015: 10 · 2014: 7 · 2013: 11 · 2012: 12
FWCI
6.88
Type
journal article
Language
en
Open access
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (K23AG028980)
  • National Institute of Allergy and Infectious Diseases (R01AI069952)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K23DK080645)
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Social Sciences › Health › Health disparities and outcomes
Keywords
end-stage renal disease, racial disparities, black-white disparities, chronic kidney disease, estimated glomerular filtration rate, mortality, veterans, kidney disease progression, racial disparities in health
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Black or African American, Female, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, Male, Middle Aged, United States, Cohort Studies, White People, Young Adult

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