Racial minority groups on dialysis in Europe: a literature review.
OBJECTIVE
To provide an overview of the existing data on non-Caucasian dialysis patients within Europe, and to explore whether these data confirm differences between non-Caucasian and Caucasian dialysis patients that were found in other parts of the world.


METHODS
A query consisting of the combination "dialysis", "ethnicity", and "Europe" was applied in PubMed, EMBASE, Web of Science, CINAHL, and the Cochrane Library.


RESULTS
Ten papers were included in this study. Studies from the United Kingdom (UK) and the Netherlands confirm the higher incidence of end-stage renal disease (ESRD) in non-Caucasians. In other European countries these findings were not confirmed. In studies from the UK, the Netherlands, and Spain a younger age at initiation of dialysis treatment for non-Caucasians compared to Caucasians was reported, this is also found in non-European studies. Regarding comorbid conditions at the start of renal replacement therapy (RRT), vascular disease was less common, while diabetes was more common among non-Caucasians compared to Caucasians. Large non-European studies also demonstrated less vascular disease among non-Caucasians initiating RRT than among Caucasians. The survival advantage for non-Caucasian compared to Caucasian RRT patients is confirmed in one large study from the UK and in a Dutch study. Reasons for the better survival of non-Caucasians are not understood completely.


CONCLUSIONS
Only a few studies are available on non-Caucasian dialysis patients in Europe. The available data confirm findings of other studies throughout the world on racial differences on dialysis. More research is needed to understand the higher incidence and better survival in non-Caucasian patients, and also in countries where there are currently no relevant data.
van den Beukel
T O
TO
Department of Clinical Epidemiology, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands.
Jager
K J
KJ
Siegert
C E H
CE
Schoones
J W
JW
Dekker
F W
FW
D015897:Comorbidity; D005006:Ethnicity; D005060:Europe; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups; D006435:Renal Dialysis / Q000706:statistics & numerical data*