Relationships of race and ethnicity to progression of kidney dysfuntion and clinical outcomes in patients with chronic kidney failure
Relationships of race and ethnicity to progression of kidney dysfuntion and clinical outcomes in patients with chronic kidney failure
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DOI：
10.1053/j.arrt.2003.10.006
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发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Lopes, AA
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作者：
Lopes, AA
在美国，黑人、美洲原住民和亚洲人的终末期肾病（ESRD）发病率远高于白人。西班牙裔人群的肾脏疾病发病率也较高。糖尿病（ESRD-DM）、高血压（ESRD-HT）和肾小球肾炎（ESRD-GN）导致的ESRD（按频率顺序排列）是美国所有人种/种族人群的主要ESRD类别。以1997年至2000年的ESRD发病率为例，以白人为参照，ESRD-HT在黑人中的发生率比（RR）最高（RR = 5.96），ESRD-DM在美洲原住民中的发生率比（RR = 5.11）最高，ESRD-GN在亚洲人中的发生率比（RR = 2.20）最高。数据表明，通过旨在预防/控制高血压和糖尿病的干预措施，可以减少在少数种族/民族中观察到的ESRD过多。数据表明，在发展为ESRD之前，少数群体的慢性肾功能衰竭患者必须面对更多的障碍才能获得高质量的医疗保健。这可能解释了为什么他们更晚去看肾脏科医生，并且在开始肾脏替代治疗（RRT）时不太可能接受肾移植。开始RRT后护理质量的改善可能解释了在少数种族/民族患者中观察到的死亡率较低和健康相关生活质量评分较高的原因。(C)2004年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
In the United States, the incidence of end-stage renal disease (ESRD) is much higher for blacks, Native Americans, and Asians than for whites. The incidence of kidney disease is also higher for populations of Hispanic ethnicity. ESRD attributed to diabetes (ESRD-DM), hypertension (ESRD-HT), and glomerulonephritis (ESRD-GN), in this order of frequency, are the major categories of ESRD in the United States for all race/ethnic groups. By using the incidence rates of ESRD, during the period from 1997 through 2000, and with whites as reference, the highest rate ratio (RR) was observed for ESRD-HT in blacks (RR = 5.96), ESRD-DM in Native Americans (RR = 5.11), and ESRD-GN in Asians (RR = 2.20). The data suggest that the excess of ESRD observed for racial/ethnic minorities may be reduced by interventions aimed at prevention/control of hypertension and diabetes. The data suggest that before developing ESRD, patients with chronic renal failure from minority groups have to face more barriers to receive high-quality health care. This may explain why they see nephrologists later and are less likely to receive renal transplantation at initiation of renal replacement therapy (RRT). Improvements in quality of care after initiating RRT may explain the lower mortality and higher scores in heath-related quality of life observed for patients from racial/ethnic minorities. (C) 2004 by the National Kidney Foundation, Inc.