Racial differences in incidence, outcome, and quality of life for African-Americans on hemodialysis.
African-Americans are the fastest growing racial minority with end-stage renal disease (ESRD) in the United States. Although comprising < 15% of the US population, African-Americans comprise approximately 31% of the ESRD population. African-Americans are approximately 7 years younger than their white counterparts with ESRD. Surprisingly, although African-Americans systematically receive less dialysis than whites, their survival with ESRD is greatly improved. This improved survival with ESRD is accompanied by an improved quality of life for African-Americans. In this review, we will examine the reasons why African-Americans have an excessive incidence of selective diseases that culminate in ESRD. Furthermore, we will judge several hypotheses that may account for the improved survival enjoyed by African-Americans with ESRD. We contend that research targeted to clarify the basis for these differences between African-Americans and whites with ESRD will improve the outcomes for both populations.
Owen
W F
WF
Division of Nephrology, Brigham and Women's Hospital, Boston, MA 02115, USA.
D001741:Black or African American; D000367:Age Factors; D044383:Black People / Q000235:genetics; D003928:Diabetic Nephropathies / Q000208:ethnology / Q000628:therapy; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000208:ethnology; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000209:etiology / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008954:Models, Biological; D015999:Multivariate Analysis; D009752:Nutritional Status; D010179:Pancreas / Q000473:pathology; D015995:Prevalence; D011788:Quality of Life; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012306:Risk; D012307:Risk Factors; D015983:Selection Bias; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology