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Risks for end-stage renal disease, cardiovascular events, and death in Hispanic versus non-Hispanic white adults with chronic kidney disease.
J Am Soc Nephrol. 2006 Oct; 17(10):2892-9.JA

Abstract

Rates of ESRD are rising faster in Hispanic than non-Hispanic white individuals, but reasons for this are unclear. Whether rates of cardiovascular events and mortality differ among Hispanic and non-Hispanic white patients with chronic kidney disease (CKD) also is not well understood. Therefore, this study examined the associations between Hispanic ethnicity and risks for ESRD, cardiovascular events, and death in patients with CKD. A total of 39,550 patients with stages 3 to 4 CKD from Kaiser Permanente of Northern California were included. Hispanic ethnicity was obtained from self-report supplemented by surname matching. GFR was estimated from the abbreviated Modification of Diet in Renal Disease equation, and clinical outcomes, patient characteristics, and longitudinal medication use were ascertained from health plan databases and state mortality files. After adjustment for sociodemographic characteristics, Hispanic ethnicity was associated with an increased risk for ESRD (hazard ratio [HR] 1.93; 95% confidence interval [CI] 1.72 to 2.17) when compared with non-Hispanic white patients, which was attenuated after controlling for diabetes and insulin use (HR 1.50; 95% CI 1.33 to 1.69). After further adjustment for potential confounders, Hispanic ethnicity remained independently associated with an increased risk for ESRD (HR 1.33; 95% CI 1.17 to 1.52) as well as a lower risk for cardiovascular events (HR 0.82; 95% CI 0.76 to 0.88) and death (HR 0.72; 95% CI 0.66 to 0.79). Among a large cohort of patients with CKD, Hispanic ethnicity was associated with lower rates of death and cardiovascular events and a higher rate of progression to ESRD. The higher prevalence of diabetes among Hispanic patients only partially explained the increased risk for ESRD. Further studies are required to elucidate the cause(s) of ethnic disparities in CKD-associated outcomes.

Authors+Show Affiliations

Division of Research, Kaiser Permanente of Northern California, 2000 Broadway Street, 3rd Floor, Oakland, CA 94612-2304, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16959827

Citation

Peralta, Carmen A., et al. "Risks for End-stage Renal Disease, Cardiovascular Events, and Death in Hispanic Versus non-Hispanic White Adults With Chronic Kidney Disease." Journal of the American Society of Nephrology : JASN, vol. 17, no. 10, 2006, pp. 2892-9.
Peralta CA, Shlipak MG, Fan D, et al. Risks for end-stage renal disease, cardiovascular events, and death in Hispanic versus non-Hispanic white adults with chronic kidney disease. J Am Soc Nephrol. 2006;17(10):2892-9.
Peralta, C. A., Shlipak, M. G., Fan, D., Ordoñez, J., Lash, J. P., Chertow, G. M., & Go, A. S. (2006). Risks for end-stage renal disease, cardiovascular events, and death in Hispanic versus non-Hispanic white adults with chronic kidney disease. Journal of the American Society of Nephrology : JASN, 17(10), 2892-9.
Peralta CA, et al. Risks for End-stage Renal Disease, Cardiovascular Events, and Death in Hispanic Versus non-Hispanic White Adults With Chronic Kidney Disease. J Am Soc Nephrol. 2006;17(10):2892-9. PubMed PMID: 16959827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risks for end-stage renal disease, cardiovascular events, and death in Hispanic versus non-Hispanic white adults with chronic kidney disease. AU - Peralta,Carmen A, AU - Shlipak,Michael G, AU - Fan,Dongjie, AU - Ordoñez,Juan, AU - Lash,James P, AU - Chertow,Glenn M, AU - Go,Alan S, Y1 - 2006/09/07/ PY - 2006/9/9/pubmed PY - 2007/1/24/medline PY - 2006/9/9/entrez SP - 2892 EP - 9 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 17 IS - 10 N2 - Rates of ESRD are rising faster in Hispanic than non-Hispanic white individuals, but reasons for this are unclear. Whether rates of cardiovascular events and mortality differ among Hispanic and non-Hispanic white patients with chronic kidney disease (CKD) also is not well understood. Therefore, this study examined the associations between Hispanic ethnicity and risks for ESRD, cardiovascular events, and death in patients with CKD. A total of 39,550 patients with stages 3 to 4 CKD from Kaiser Permanente of Northern California were included. Hispanic ethnicity was obtained from self-report supplemented by surname matching. GFR was estimated from the abbreviated Modification of Diet in Renal Disease equation, and clinical outcomes, patient characteristics, and longitudinal medication use were ascertained from health plan databases and state mortality files. After adjustment for sociodemographic characteristics, Hispanic ethnicity was associated with an increased risk for ESRD (hazard ratio [HR] 1.93; 95% confidence interval [CI] 1.72 to 2.17) when compared with non-Hispanic white patients, which was attenuated after controlling for diabetes and insulin use (HR 1.50; 95% CI 1.33 to 1.69). After further adjustment for potential confounders, Hispanic ethnicity remained independently associated with an increased risk for ESRD (HR 1.33; 95% CI 1.17 to 1.52) as well as a lower risk for cardiovascular events (HR 0.82; 95% CI 0.76 to 0.88) and death (HR 0.72; 95% CI 0.66 to 0.79). Among a large cohort of patients with CKD, Hispanic ethnicity was associated with lower rates of death and cardiovascular events and a higher rate of progression to ESRD. The higher prevalence of diabetes among Hispanic patients only partially explained the increased risk for ESRD. Further studies are required to elucidate the cause(s) of ethnic disparities in CKD-associated outcomes. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/16959827/Risks_for_end_stage_renal_disease_cardiovascular_events_and_death_in_Hispanic_versus_non_Hispanic_white_adults_with_chronic_kidney_disease_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=16959827 DB - PRIME DP - Unbound Medicine ER -