title: Racial and ethnic differences in mortality among individuals with chronic kidney disease: results from the Kidney Early Evaluation Program (KEEP).
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is prevalent in minority populations and racial/ethnic differences in survival are incompletely understood.
  
  
  METHODS
  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.
authors.affiliation: Cleveland Clinic Medicine Institute, 9500 Euclid Avenue/G10, Cleveland, Ohio 44195, USA. jollys@ccf.org
authors.forename: Stacey E
authors.initials: SE
authors.lastname: Jolly
authors.forename: Nilka Ríos
authors.initials: NR
authors.lastname: Burrows
authors.forename: Shu-Cheng
authors.initials: SC
authors.lastname: Chen
authors.forename: Suying
authors.initials: S
authors.lastname: Li
authors.forename: Claudine T
authors.initials: CT
authors.lastname: Jurkovitz
authors.forename: Keith C
authors.initials: KC
authors.lastname: Norris
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003153:Community Health Services; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology