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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Epidemiol
2016 ; 26
(11
): 780-787.e1
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Racial differences in renal replacement therapy initiation among children with a
nonglomerular cause of chronic kidney disease
#MMPMID27789133
Ng DK
; Moxey-Mims M
; Warady BA
; Furth SL
; Muñoz A
Ann Epidemiol
2016[Nov]; 26
(11
): 780-787.e1
PMID27789133
show ga
PURPOSE: African American (AA) adults with chronic kidney disease (CKD) have a
faster progression to end-stage renal disease and are less likely to receive a
kidney transplant. It is unclear whether AA children experience renal replacement
therapy (RRT) for end-stage renal disease sooner than non-AA children after
accounting for socioeconomic status (SES). METHODS: Among children with
nonglomerular CKD in the Chronic Kidney Disease in Children study, we
investigated time to RRT (i.e., first dialysis or transplant) after CKD onset
using parametric survival models and accounted for SES differences by inverse
probability weights. RESULTS: Of 110 AA and 493 non-AA children (median
age = 10 years), AA children had shorter time to first RRT: median time was
3.2 years earlier than non-AA children (95% CI: -6.1, -0.3). When accounting for
SES, this difference was diminished and nonsignificant (-1.6 years; 95%
CI: -4.6, +1.5), and its directionality was consistent with faster glomerular
filtration rate decline among AA children (-6.2% vs. -4.4% per year, P = .098).
When RRT was deconstructed into dialysis or transplant, the time to dialysis was
37.5% shorter for AA children and 53.7% longer for transplant. These inferences
were confirmed by the frequency and timing of transplant after initiating
dialysis. CONCLUSIONS: Racial differences in time to RRT were almost fully
accounted for by SES, and the remaining difference was congruent with a faster
glomerular filtration rate decline among AA children. Access to transplant
occurred later, yet times to dialysis were shorter among AA children even when
accounting for SES which may be due to a lack of organ availability.
|Adolescent
[MESH]
|Black or African American/statistics & numerical data
[MESH]