Ethnicity and survival on dialysis in west London.
BACKGROUND
Indo-Asian and Afro-Caribbean patients have higher rates of renal failure and requirement for renal replacement therapy than the general population in the UK. Despite this, information regarding survival on dialysis is limited.


METHODS
The incident hemodialysis population of a large west London renal service was reviewed from 1996 to 2001 (N = 465).


RESULTS
The cohort's ethnic background was Indo-Asian (30.8%), Caucasian (49%), Afro-Caribbean (18.3%), and other (1.9%). Indo-Asians and Afro-Caribbeans were younger than Caucasian patients, with a higher rate of diabetes mellitus. Survival on hemodialysis for Indo-Asians was 97.5% and 81.6% at 1 and 3 years, respectively, compared with 92.7% and 75.2% for Caucasians, and 97.5% and 85.3% for Afro-Caribbeans (P = nonsignificant). Dialysis adequacy was observed to be associated with survival. Patients with mean single pool Kt/V of over 1.4 had survival of 90.6% and 74.8% at 2 and 5 years, respectively, compared with 74.0% and 42.9% for those with Kt/V less than 1.4 (P < 0.001). There were significantly more patients in the Indo-Asian cohort with a mean Kt/V of 1.4 or over (87.4%) compared with Caucasians (57.6%) and Afro-Caribbeans (52.4%), and the benefit of higher Kt/V was seen in all ethnic groups. In a multivariate analysis of factors including Kt/V over 1.4, age, diabetic status, gender, and ethnicity, Indo-Asian or Afro-Caribbean ethnicity did not confer a survival disadvantage. The strongest predictors of survival were age and dialysis adequacy.


CONCLUSIONS
Indo-Asian and Afro-Caribbean hemodialysis patients have survival comparable to Caucasians despite a higher burden of diabetes.
Prasad
Shilpanjali
S
shilpa.prasad@nwahs.sa.gov.au
Singh
Seema
S
Duncan
Neill
N
Cairns
Tom D H
TD
Griffith
Megan
M
Hakim
Nadey
N
McLean
Adam G
AG
Palmer
Andrew
A
Papalois
Vassilios
V
Taube
David
D
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001208:Asia / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D002423:Cause of Death; D003928:Diabetic Nephropathies / Q000208:ethnology / Q000401:mortality; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000401:mortality*; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data