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White/black racial differences in risk of end-stage renal disease and death.
Open accessAbstract
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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“Black patients have a disproportionately higher burden of cardiovascular and advanced kidney disease.12,13,14,15,16,17,18,19,20”
From Association of race/ethnicity, gender, and socioeconomic status with sodium-glucose cotransporter 2 inhibitor use among patients with diabetes in the US (2021) · cites this paper as [12]
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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.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 122
- Issue
- 7
- Pages
- 672-678
- ISSN
- 0002-9343 (ISSN-L)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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