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Comparative Study
. 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)

Stacey E Jolly  1 , Nilka Ríos Burrows, Shu-Cheng Chen, Suying Li, Claudine T Jurkovitz, Keith C Norris, Michael G Shlipak
Affiliations
Comparative Study

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

Stacey E Jolly et al. Clin J Am Soc Nephrol. 2011 Aug.

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.

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Figures

Figure 1.
Figure 1.
Flow diagram illustrating how the cohort was built for analyses for this study.
Figure 2.
Figure 2.
Racial/ethnic differences in death rates among participants with chronic kidney disease, Kidney Early Evaluation Program, 2000 through 2009.
See this image and copyright information in PMC

References

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