title: Black ethnicity predicts better survival on dialysis despite greater deprivation and co-morbidity: a UK study.
abstract: BACKGROUND
  Observational studies from the United States have identified black race as conferring a survival advantage on dialysis. This study represents the first large single-center study from a UK dialysis unit examining the outcome of ethnic minorities on renal replacement therapy (RRT).
  
  
  METHODS
  A retrospective analysis of all patients of white or black race initiating RRT at King's College Hospital Renal Unit, London, between 1996 and 2008 was performed. A total of 1,340 patients were studied, of which 952 (71%) were of white race, and 388 (29%) were of black race. Kaplan-Meier survival curves, the log rank test and Cox's proportional hazard models were used to compare survival between groups.
  
  
  RESULTS
  The results revealed black ethnicity to be associated with a significant survival benefit on dialysis. This was the case even after adjustment for age, gender, diabetes, transplantation, and deprivation. In those patients not transplanted, black race conferred a hazard ratio (HR) of 0.51 (95% CI 0.41 - 0.63) over 5 years.
  
  
  CONCLUSIONS
  This study provides evidence for a lower mortality rate amongst black patients on dialysis in comparison with their white counterparts in the UK. The reasons behind this remain poorly understood but a lower incidence of cardiovascular disease in black patients and more kidney-limited disease may be important.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cole
authors.forename: Michael
authors.initials: M
authors.lastname: Bedford
authors.forename: Andrew
authors.initials: A
authors.lastname: Cai
authors.forename: Chris
authors.initials: C
authors.lastname: Jones
authors.forename: Hugh
authors.initials: H
authors.lastname: Cairns
authors.forename: Satish
authors.initials: S
authors.lastname: Jayawardene
mesh_terms: D044383:Black People / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*