American Journal of Kidney Diseases
Volume 55, Issue 6 , Pages 1102-1110 , June 2010

Reappraisal of the Impact of Race on Survival in Patients on Dialysis

  • Vardaman M. Buckalew Jr, MD
  • ,
  • Barry I. Freedman, MD

      Affiliations

    • Corresponding Author InformationAddress correspondence to Barry I. Freedman, MD, Section on Nephrology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1053

Received 7 August 2009 ,Accepted 27 October 2009.

References 

  1. Agodoa L, Eggers P. Racial and ethnic disparities in end-stage kidney failure—survival paradoxes in African-Americans. Semin Dial. 2007;20:577–585
  2. Xue JL, Eggers PW, Agodoa LY, Foley RN, Collins AJ. Longitudinal study of racial and ethnic differences in developing end-stage renal disease among aged Medicare beneficiaries. J Am Soc Nephrol. 2007;18:1299–1306
  3. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298:2038–2047
  4. Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2003;41:1–12
  5. Coresh J, Byrd-Holt D, Astor BC, et al. Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J Am Soc Nephrol. 2005;16:180–188
  6. McClellan W, Warnock DG, McClure L, et al. Racial differences in the prevalence of chronic kidney disease among participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort Study. J Am Soc Nephrol. 2006;17:1710–1715
  7. Newsome BB, McClellan WM, Allison JJ, et al. Racial differences in the competing risks of mortality and ESRD after acute myocardial infarction. Am J Kidney Dis. 2008;52:251–261
  8. Choi AI, Rodriguez RA, Bacchetti P, Bertenthal D, Hernandez GT, O'Hare AM. White/black racial differences in risk of end-stage renal disease and death. Am J Med. 2009;122:672–678
  9. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130(6):461–470
  10. Foley RN, Murray AM, Li S, et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol. 2005;16:489–495
  11. Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med. 2004;164:659–663
  12. Kovesdy CP, Anderson JE, Derose SF, Kalantar-Zadeh K. Outcomes associated with race in males with nondialysis-dependent chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:973–978
  13. Hsu CY, Lin F, Vittinghoff E, Shlipak MG. Racial differences in the progression from chronic renal insufficiency to end-stage renal disease in the United States. J Am Soc Nephrol. 2003;14:2902–2907
  14. Walker WG, Neaton JD, Cutler JA, Neuwirth R, Cohen JD The MRFIT Research Group. Renal function change in hypertensive members of the Multiple Risk Factor Intervention Trial (Racial and treatment effects). JAMA. 1992;268:3085–3091
  15. Hunsicker LG, Adler S, Caggiula A, et al. Predictors of the progression of renal disease in the Modification of Diet in Renal Disease Study. Kidney Int. 1997;51:1908–1919
  16. Regalado M, Yang S, Wesson DE. Cigarette smoking is associated with augmented progression of renal insufficiency in severe essential hypertension. Am J Kidney Dis. 2000;35:687–694
  17. Brancati FL, Whittle JC, Whelton PK, Seidler AJ, Klag MJ. The excess incidence of diabetic end-stage renal disease among blacks (A population-based study of potential explanatory factors). JAMA. 1992;268(21):3079–3084
  18. Tarver-Carr ME, Powe NR, Eberhardt MS, et al. Excess risk of chronic kidney disease among African-American versus white subjects in the United States: a population-based study of potential explanatory factors. J Am Soc Nephrol. 2002;13:2363–2370
  19. Appel LJ, Wright JT, Greene T, et al. Long-term effects of renin-angiotensin system-blocking therapy and a low blood pressure goal on progression of hypertensive chronic kidney disease in African Americans. Arch Intern Med. 2008;168:832–839
  20. Rahman M, Pressel S, Davis BR, et al. Cardiovascular outcomes in high-risk hypertensive patients stratified by baseline glomerular filtration rate. Ann Intern Med. 2006;144:172–180
  21. Newsome BB, McClellan WM, Coffey CS, Allison JJ, Kiefe CI, Warnock DG. Survival advantage of black patients with kidney disease after acute myocardial infarction. Clin J Am Soc Nephrol. 2006;1:993–999
  22. US Renal Data System. USRDS 2008 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2008;
  23. Whittle JC, Whelton PK, Seidler AJ, Klag MJ. Does racial variation in risk factors explain black-white differences in the incidence of hypertensive end-stage renal disease?. Arch Intern Med. 1991;151:1359–1364
  24. Southeastern Kidney Council Inc, ESRD Network 6. Annual Report. 1993;
  25. Cantor ES, Kimmel PL, Bosch JP. Effect of race on expression of acquired immunodeficiency syndrome-associated nephropathy. Arch Intern Med. 1991;151:125–128
  26. Seaquist ER, Goetz FC, Rich S, Barbosa J. Familial clustering of diabetic kidney disease (Evidence for genetic susceptibility to diabetic nephropathy). N Engl J Med. 1989;320(18):1161–1165
  27. Freedman BI, Tuttle AB, Spray BJ. Familial predisposition to nephropathy in African-Americans with non-insulin dependent diabetes mellitus. Am J Kidney Dis. 1995;25:710–713
  28. Lei HH, Perneger TV, Klag MJ, Whelton PK, Coresh J. Familial aggregation of renal disease in a population-based case-control study. J Am Soc Nephrol. 1998;9(7):1270–1276
  29. Freedman BI, Spray BJ, Tuttle AB, Buckalew VM. The familial risk of end-stage renal disease in African Americans. Am J Kidney Dis. 1993;21:387–393
  30. Freedman BI, Volkova NV, Satko SG, et al. Population-based screening for family history of end-stage renal disease among incident dialysis patients. Am J Nephrol. 2005;25(6):529–535
  31. Freedman BI, Soucie JM, Stone SM, Pegram S. Familial clustering of end-stage renal disease in blacks with HIV-associated nephropathy. Am J Kidney Dis. 1999;34(2):254–258
  32. Freedman BI, Wilson CH, Spray BJ, Tuttle AB, Olorenshaw IM, Kammer GM. Familial clustering of end-stage renal disease in blacks with lupus nephritis. Am J Kidney Dis. 1997;29(5):729–732
  33. Freedman BI, Soucie JM, McClellan WM. Family history of end-stage renal disease among incident dialysis patients. J Am Soc Nephrol. 1997;8:1942–1945
  34. Freedman BI. Familial aggregation of end-stage renal failure: aetiological implications. Nephrol Dial Transplant. 1999;14:295–297
  35. Kopp JB, Smith MW, Nelson GW, et al. MYH9 is a major-effect risk gene for focal segmental glomerulosclerosis. Nat Genet. 2008;40:1175–1184
  36. Kao WH, Klag MJ, Meoni LA, et al. MYH9 is associated with nondiabetic end-stage renal disease in African Americans. Nat Genet. 2008;40:1185–1192
  37. Freedman BI, Hicks PJ, Bostrom MA, et al. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) are strongly associated with end-stage renal disease historically attributed to hypertension in African Americans. Kidney Int. 2009;75:736–745
  38. Freedman BI, Hicks PJ, Bostrom MA, et al. Non-muscle myosin heavy chain 9 gene MYH9 associations in African Americans with clinically diagnosed type 2 diabetes mellitus-associated ESRD. Nephrol Dial Transplant. 2009;24(11):3366–3371
  39. Pattaro C, Aulchenko YS, Isaacs A, et al. Genome-wide linkage analysis of serum creatinine in three isolated European populations. Kidney Int. 2009;76:297–306
  40. Freedman BI, Kopp JB, Winkler CA, et al. Polymorphisms in the nonmuscle myosin heavy chain 9 gene (MYH9) are associated with albuminuria in hypertensive African Americans: the HyperGEN Study. Am J Nephrol. 2009;29:626–632
  41. Mesler DE, McCarthy EP, Byrne-Logan S, Ash AS, Moskowitz MA. Does the survival advantage of nonwhite dialysis patients persist after case mix adjustment?. Am J Med. 1999;106:300–306
  42. Robinson BM, Joffe MM, Pisoni RL, Port FK, Feldman HI. Revisiting survival differences by race and ethnicity among hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study. J Am Soc Nephrol. 2006;17:2910–2918
  43. Pei YP, Greenwood CM, Chery AL, Wu GG. Racial differences in survival of patients on dialysis. Kidney Int. 2000;58:1293–1299
  44. Bleyer AJ, Tell GS, Evans GW, Ettinger WH, Burkart JM. Survival of patients undergoing renal replacement therapy in one center with special emphasis on racial differences. Am J Kidney Dis. 1996;28:72–81
  45. Eknoyan G, Beck GJ, Cheung AK, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med. 2002;347:2010–2019
  46. Fink JC, Burdick RA, Kurth SJ, et al. Significance of serum creatinine values in new end-stage renal disease patients. Am J Kidney Dis. 1999;34:694–701
  47. Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int. 2003;63(3):793–808
  48. Trivedi H, Xiang Q, Klein JP. Risk factors for non-fatal myocardial infarction and cardiac death in incident dialysis patients. Nephrol Dial Transplant. 2009;24:258–266
  49. Obrador GT, Arora P, Kausz AT, Ruthazer R, Pereira BJ, Levey AS. Level of renal function at the initiation of dialysis in the U.S. end-stage renal disease population. Kidney Int. 1999;56:2227–2235
  50. Levine RS, Foster JE, Fullilove RE, et al. Black-white inequalities in mortality and life expectancy, 1933-1999: implications for healthy people 2010. Public Health Rep. 2001;116:474–483
  51. Mensah GA, Brown DW, Croft JB, Greenlund KJ. Major coronary risk factors and death from coronary heart disease: baseline and follow-up mortality data from the Second National Health and Nutrition Examination Survey (NHANES II). Am J Prev Med. 2005;29:68–74
  52. Geronimus AT, Bound J, Waidmann TA, Hillemeier MM, Burns PB. Excess mortality among blacks and whites in the United States. N Engl J Med. 1996;335:1552–1558
  53. Weiner DE, Tighiouart H, Amin MG, et al. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol. 2004;15(5):1307–1315
  54. Mehrotra R, Kermah D, Fried L, Adler S, Norris K. Racial differences in mortality among those with CKD. J Am Soc Nephrol. 2008;19:1403–1410
  55. Young BA, Rudser K, Kestenbaum B, Seliger SL, Andress D, Boyko EJ. Racial and ethnic differences in incident myocardial infarction in end-stage renal disease patients: the USRDS. Kidney Int. 2006;69:1691–1698
  56. Karnik JA, Young BS, Lew NL, et al. Cardiac arrest and sudden death in dialysis units. Kidney Int. 2001;60:350–357
  57. Bleyer AJ, Russell GB, Satko SG. Sudden and cardiac death rates in hemodialysis patients. Kidney Int. 1999;55:1553–1559
  58. Cheung AK, Sarnak MJ, Yan G, et al. Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney Int. 2000;58:353–362
  59. Stack AG, Bloembergen WE. Prevalence and clinical correlates of coronary artery disease among new dialysis patients in the United States: a cross-sectional study. J Am Soc Nephrol. 2001;12:1516–1523
  60. Volkova N, McClellan W, Soucie JM, Schoolwerth A. Racial disparities in the prevalence of cardiovascular disease among incident end-stage renal disease patients. Nephrol Dial Transplant. 2006;21:2202–2209
  61. Trespalacios FC, Taylor AJ, Agodoa LY, Abbott KC. Incident acute coronary syndromes in chronic dialysis patients in the United States. Kidney Int. 2002;62:1799–1805
  62. Marcantoni C, Ma LJ, Federspiel C, Fogo AB. Hypertensive nephrosclerosis in African Americans versus Caucasians. Kidney Int. 2002;62:172–180
  63. Fogo A, Breyer JA, Smith MC, et al. Accuracy of the diagnosis of hypertensive nephrosclerosis in African Americans: a report from the African American Study of Kidney Disease (AASK) Trial. AASK Pilot Study Investigators. Kidney Int. 1997;51:244–252
  64. Bleyer AJ, Chen R, D'Agostino RB, Appel RG. Clinical correlates of hypertensive end-stage renal disease. Am J Kidney Dis. 1998;31:28–34
  65. Appel RG, Bleyer AJ, Burkart JM. Does hypertension cause end-stage renal disease in older white patients?. Nephron. 1998;78:332–333
  66. Lipkowitz MS, Iyengar S, Molineros J, et al. ; and AASK Investigators (Association analysis of the non-muscle myosin heavy chain 9 gene (MYH9) in hypertensive nephropathy: African American Study of Kidney Disease and Hypertension (AASK) [abstract]). J Am Soc Nephrol. 2009;20:56A
  67. Freedman BI, Sedor JR. Hypertension-associated kidney disease: perhaps no more. J Am Soc Nephrol. 2008;19:2047–2051
  68. Karter AJ, Ferrara A, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA. 2002;287:2519–2527
  69. Young BA, Maynard C, Boyko EJ. Racial differences in diabetic nephropathy, cardiovascular disease, and mortality in a national population of veterans. Diabetes Care. 2003;26:2392–2399
  70. Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358(13):1336–1345
  71. Bild DE, Detrano R, Peterson D, et al. Ethnic differences in coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2005;111(10):1313–1320
  72. Newman AB, Naydeck BL, Whittle J, Sutton-Tyrrell K, Edmundowicz D, Kuller LH. Racial differences in coronary artery calcification in older adults. Arterioscler Thromb Vasc Biol. 2002;22(3):424–430
  73. Freedman BI, Langefeld CD, Lohman KK, et al. Relationship between albuminuria and cardiovascular disease in type 2 diabetes. J Am Soc Nephrol. 2005;16(7):2156–2161
  74. Budoff MJ, Nasir K, Mao S, et al. Ethnic differences of the presence and severity of coronary atherosclerosis. Atherosclerosis. 2006;187(2):343–350
  75. Carnethon MR, Bertoni AG, Shea S, et al. Racial/ethnic differences in subclinical atherosclerosis among adults with diabetes: the Multiethnic Study of Atherosclerosis. Diabetes Care. 2005;28:2768–2770
  76. Gorelick PB, Caplan LR, Hier DB, Parker SL, Patel D. Racial differences in the distribution of anterior circulation occlusive disease. Neurology. 1984;34:54–59
  77. Inzitari D, Hachinski VC, Taylor DW, Barnett HJ. Racial differences in the anterior circulation in cerebrovascular disease (How much can be explained by risk factors?). Arch Neurol. 1990;47:1080–1084
  78. Gil-Peralta A, Alter M, Lai SM, et al. Duplex Doppler and spectral flow analysis of racial differences in cerebrovascular atherosclerosis. Stroke. 1990;21:740–744
  79. Divers J, Wagenknecht LE, Bowden DW, et al. Ethnic differences in the relationship between albuminuria and calcified atherosclerotic plaque: African American-Diabetes Heart Study. Diabetes Care. 2010;33(1):131–138
  80. Braun J, Oldendorf M, Moshage W, Heidler R, Zeitler E, Luft FC. Electron beam computed tomography in the evaluation of cardiac calcifications in chronic dialysis patients. Am J Kidney Dis. 1996;27:394–401
  81. Russo D, Palmiero G, De Blasio AP, Balletta MM, Andreucci VE. Coronary artery calcification in patients with CRF not undergoing dialysis. Am J Kidney Dis. 2004;44:1024–1030
  82. Bellasi A, Veledar E, Ferramosca E, Ratti C, Block G, Raggi P. Markers of vascular disease do not differ in black and white hemodialysis patients despite a different risk profile. Atherosclerosis. 2008;197:242–249
  83. Wagenknecht LE, Bowden DW, Carr JJ, Langefeld CD, Freedman BI, Rich SS. Familial aggregation of coronary artery calcium in families with type 2 diabetes. Diabetes. 2001;50(4):861–866
  84. Lange LA, Bowden DW, Langefeld CD, et al. Heritability of carotid artery intima-medial thickness in type 2 diabetes. Stroke. 2002;33(7):1876–1881
  85. Peyser PA, Bielak LF, Chu JS, et al. Heritability of coronary artery calcium quantity measured by electron beam computed tomography in asymptomatic adults. Circulation. 2002;106(3):304–308
  86. Wagenknecht LE, Bertoni AG, Divers J, et al. I (Correlates of coronary artery calcified plaque in African Americans and European Americans with diabetes [abstract]). Diabetes. 2009;58(suppl 1):A252
  87. Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V. Aortic calcification and the risk of osteoporosis and fractures. J Clin Endocrinol Metab. 2004;89:4246–4253
  88. Shao JS, Cai J, Towler DA. Molecular mechanisms of vascular calcification: lessons learned from the aorta. Arterioscler Thromb Vasc Biol. 2006;26:1423–1430
  89. Gaillard T, Schuster D, Osei K. Metabolic syndrome in black people of the African diaspora: the paradox of current classification, definition and criteria. Ethn Dis. 2009;19(suppl 2):S2–S7
  90. Smith MW, Patterson N, Lautenberger JA, et al. A high-density admixture map for disease gene discovery in african americans. Am J Hum Genet. 2004;74:1001–1013
  91. Divers J, Moossavi S, Langefeld CD, Freedman BI. Genetic admixture: a tool to identify diabetic nephropathy genes in African Americans. Ethn Dis. 2008;18:384–388

 Originally published online as doi:10.1053/j.ajkd.2009.10.062 on February 8, 2010.

PII: S0272-6386(09)01651-5

doi: 10.1053/j.ajkd.2009.10.062

American Journal of Kidney Diseases
Volume 55, Issue 6 , Pages 1102-1110 , June 2010