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Differences in survival between black and white patients with diabetic end-stage renal disease.
Diabetes Care 1994; 17(7):681-7DC

Abstract

OBJECTIVE

To evaluate whether the longer survival of blacks with diabetic end-stage renal disease (ESRD) relative to whites is due to racial differences in type of diabetes, comorbidity at ESRD onset, and ESRD treatment modality and to examine whether survival differences between blacks and whites occur only in certain population subgroups.

RESEARCH DESIGN AND METHODS

The Michigan Kidney Registry was used to ascertain all blacks and whites (n = 594) with diabetic ESRD in southeastern Michigan, with ESRD onset at age < 65 years during 1974-1983. Patients were followed through 1988. Medical records were abstracted for type of diabetes, comorbidity at ESRD onset, and other factors.

RESULTS

Median survival among insulin-dependent diabetes mellitus patients was 27 months in blacks and 17 months in whites, and among non-insulin-dependent diabetes mellitus patients was 30 months in blacks and 16 months in whites. After adjustment for confounding factors by Cox proportional hazards analysis, the death rate was 45% lower in blacks than in whites on dialysis (relative death rate [RDR] = 0.55, 95% confidence interval [CI] = 0.44-0.69), but was similar in blacks and whites with a renal transplant (RDR = 0.99, 95% CI = 0.64-1.52). Compared with dialysis, transplantation was associated with lower mortality in both races (white, RDR = 0.50, 95% CI = 0.36-0.70; blacks, RDR = 0.89, 95% CI = 0.60-1.34), although the effect was not statistically significant in blacks. Racial differences in survival did not vary by type of diabetes or any additional factor.

CONCLUSIONS

Survival after ESRD onset is longer in blacks than in whites treated with dialysis, even after adjusting for comorbidity and other factors that affect survival. Survival does not differ by race among transplant patients.

Authors+Show Affiliations

MPH, Social & Scientific Systems, Inc., Bethesda, MD 20814.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7924777

Citation

Cowie, C C., et al. "Differences in Survival Between Black and White Patients With Diabetic End-stage Renal Disease." Diabetes Care, vol. 17, no. 7, 1994, pp. 681-7.
Cowie CC, Port FK, Rust KF, et al. Differences in survival between black and white patients with diabetic end-stage renal disease. Diabetes Care. 1994;17(7):681-7.
Cowie, C. C., Port, F. K., Rust, K. F., & Harris, M. I. (1994). Differences in survival between black and white patients with diabetic end-stage renal disease. Diabetes Care, 17(7), pp. 681-7.
Cowie CC, et al. Differences in Survival Between Black and White Patients With Diabetic End-stage Renal Disease. Diabetes Care. 1994;17(7):681-7. PubMed PMID: 7924777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in survival between black and white patients with diabetic end-stage renal disease. AU - Cowie,C C, AU - Port,F K, AU - Rust,K F, AU - Harris,M I, PY - 1994/7/1/pubmed PY - 1994/7/1/medline PY - 1994/7/1/entrez SP - 681 EP - 7 JF - Diabetes care JO - Diabetes Care VL - 17 IS - 7 N2 - OBJECTIVE: To evaluate whether the longer survival of blacks with diabetic end-stage renal disease (ESRD) relative to whites is due to racial differences in type of diabetes, comorbidity at ESRD onset, and ESRD treatment modality and to examine whether survival differences between blacks and whites occur only in certain population subgroups. RESEARCH DESIGN AND METHODS: The Michigan Kidney Registry was used to ascertain all blacks and whites (n = 594) with diabetic ESRD in southeastern Michigan, with ESRD onset at age < 65 years during 1974-1983. Patients were followed through 1988. Medical records were abstracted for type of diabetes, comorbidity at ESRD onset, and other factors. RESULTS: Median survival among insulin-dependent diabetes mellitus patients was 27 months in blacks and 17 months in whites, and among non-insulin-dependent diabetes mellitus patients was 30 months in blacks and 16 months in whites. After adjustment for confounding factors by Cox proportional hazards analysis, the death rate was 45% lower in blacks than in whites on dialysis (relative death rate [RDR] = 0.55, 95% confidence interval [CI] = 0.44-0.69), but was similar in blacks and whites with a renal transplant (RDR = 0.99, 95% CI = 0.64-1.52). Compared with dialysis, transplantation was associated with lower mortality in both races (white, RDR = 0.50, 95% CI = 0.36-0.70; blacks, RDR = 0.89, 95% CI = 0.60-1.34), although the effect was not statistically significant in blacks. Racial differences in survival did not vary by type of diabetes or any additional factor. CONCLUSIONS: Survival after ESRD onset is longer in blacks than in whites treated with dialysis, even after adjusting for comorbidity and other factors that affect survival. Survival does not differ by race among transplant patients. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/7924777/Differences_in_survival_between_black_and_white_patients_with_diabetic_end_stage_renal_disease_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -