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Racial differences in survival in an urban peritoneal dialysis program
S M Korbet1, D Shih, K N Cline
1Department of Medicine, Rush Presbyterian St. Lukes Medical Center, Chicago, IL, USA.
Summary
Black patients demonstrate superior long-term survival on peritoneal dialysis (PD) compared to white patients. This study highlights PD as a viable treatment option for Black individuals with end-stage renal disease.
Area of Science:
- Nephrology
- Public Health
Background:
- Racial disparities in end-stage renal disease (ESRD) outcomes are a significant concern.
- Peritoneal dialysis (PD) is a common treatment modality for ESRD, but its effectiveness across different racial groups requires investigation.
Purpose of the Study:
- To investigate potential racial differences in patient survival within a peritoneal dialysis program.
- To identify factors influencing mortality in patients undergoing PD.
Main Methods:
- Retrospective analysis of 233 incident PD patients from January 1987 to September 1997.
- Collected data included clinical features, comorbidities, nutritional status, and dialysis dose.
- Cox proportional hazards analysis was used to identify predictors of mortality.
Main Results:
- White race was independently associated with increased mortality risk (RR: 2.35) compared to Black patients.
- Survival rates at 1, 2, and 5 years were consistently higher for Black patients across all analyses (diabetic and non-diabetic).
- Factors like age, cardiac disease, peripheral vascular disease, cerebrovascular disease, and serum albumin also predicted mortality.
Conclusions:
- Long-term patient survival on PD is significantly better for Black patients than for white patients.
- Peritoneal dialysis should be considered a viable treatment option for Black patients with ESRD.
- Further research into the underlying causes of these racial survival differences is warranted.