title: Survival of patients from South Asian and Black populations starting renal replacement therapy in England and Wales.
abstract: BACKGROUND
  South Asian and Black ethnic minorities in the UK have higher rates of acceptance onto renal replacement therapy (RRT) than Caucasians. Registry studies in the USA and Canada show better survival; there are few data in the UK.
  
  
  METHODS
  Renal Association UK Renal Registry data were used to compare the characteristics and survival of patients starting RRT from both groups with those of Caucasians, using incident cases accepted between 1997 and 2006. Survival was analysed by multivariate Cox's proportional hazards regression split by haemodialysis and peritoneal dialysis (PD) due to non-proportionality, and without censoring at transplantation.
  
  
  RESULTS
  A total of 2495 (8.2%) were South Asian and 1218 (4.0%) were Black. They were younger and had more diabetic nephropathy. The age-adjusted prevalence of vascular co-morbidity was higher in South Asians and lower in Blacks; other co-morbidities were generally common in Caucasians. Late referral did not differ. They were less likely to receive a transplant or to start PD. South Asians and Blacks had significantly better survival than Caucasians both from RRT start to Day 90 and after Day 90, and for those on HD or PD at Day 90. Fully adjusted hazard ratios after Day 90 on haemodialysis were 0.70 (0.55-0.89) for South Asians and 0.56 (0.41-0.75) for Blacks.
  
  
  CONCLUSIONS
  South Asian and Black minorities have better survival on dialysis. An understanding of the mechanisms may provide general insights for all patients on RRT.
authors.affiliation: Public Health Sciences and Medical Statistics, University of Southampton, C floor, South Academic Block, Southampton General Hospital, Southampton SO166YD, UK. pjr@soton.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Roderick
authors.forename: Catherine
authors.initials: C
authors.lastname: Byrne
authors.forename: Anna
authors.initials: A
authors.lastname: Casula
authors.forename: Retha
authors.initials: R
authors.lastname: Steenkamp
authors.forename: David
authors.initials: D
authors.lastname: Ansell
authors.forename: Richard
authors.initials: R
authors.lastname: Burden
authors.forename: Dorothea
authors.initials: D
authors.lastname: Nitsch
authors.forename: Terry
authors.initials: T
authors.lastname: Feest
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D044466:Asian People; D044383:Black People; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017582:Renal Replacement Therapy / Q000401:mortality*; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology; D044465:White People