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Titolo:
SURVIVAL OF PATIENTS UNDERGOING RENAL REPLACEMENT THERAPY IN ONE-CENTER WITH SPECIAL EMPHASIS ON RACIAL-DIFFERENCES
Autore:
BLEYER AJ; TELL GS; EVANS GW; ETTINGER WH; BURKART JM;
Indirizzi:
WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT INTERNAL MED,NEPHROL SECT,MED CTR BLVD WINSTON SALEM NC 27157 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27157 UNIV BERGEN,DEPT PUBL HLTH & PRIMARY HLTH CARE BERGEN NORWAY
Titolo Testata:
American journal of kidney diseases
fascicolo: 1, volume: 28, anno: 1996,
pagine: 72 - 81
SICI:
0272-6386(1996)28:1<72:SOPURR>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; DISEASE; RISK; NEPHROPATHY; PREVALENCE;
Keywords:
HEMODIALYSIS; RACE; PATIENT SURVIVAL; PERITONEAL DIALYSIS; TRANSPLANTATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
A.J. Bleyer et al., "SURVIVAL OF PATIENTS UNDERGOING RENAL REPLACEMENT THERAPY IN ONE-CENTER WITH SPECIAL EMPHASIS ON RACIAL-DIFFERENCES", American journal of kidney diseases, 28(1), 1996, pp. 72-81

Abstract

This study compared racial differences in end-stage renal disease (ESRD) in 550 patients starting renal replacement therapy at a large academic dialysis center between January 1, 1990, and December 31, 1993, with followup through December 31, 1994. Patient groups were compared with respect to cause of ESRD, comorbid factors at the start of dialysis therapy, choice of modality, transplantation rate, and survival, Fifty-eight percent of the patients were white and 42% were African-American. There was a similar distribution of causes of ESRD between races. African-American patients were less likely to choose peritoneal dialysis as initial therapy (11.6% v 29.3%; P < 0.001) and were less likelyto change dialysis modality. Transplantation rates were significantlydifferent between African-American and white patients (9.3% v 27.6%; P < 0.001). African-Americans less frequently received living-related,living-nonrelated, and cadaveric renal transplants, Given differencesin transplantation rates and in survival of transplanted patients versus patients on dialysis, survival analysis was performed without censoring for transplantation. A multivariate Cox proportional hazards model was formed, and the following were identified as being significant independent predictors of survival: age, race, age-race interaction, serum albumin at the start of dialysis, activity level at the start of dialysis, and presence of congestive heart failure and cancer, Age hadlittle effect on survival among African-American patients, while it was a significant predictor of survival in white patients, In the groupof patients starting dialysis before the age of 30 years, African-American patients had a significantly increased mortality risk compared with white patients. However, white patients older than 50 years had a higher mortality risk; this risk difference increased with age. Racialdifferences in mortality among older white patients could not be explained by differences in comorbid conditions, transplantation rates, orwithdrawal from dialysis. (C) 1996 by the National Kidney Foundation,Inc.

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Documento generato il 30/11/20 alle ore 16:52:49