Tuesday, July 16, 2013
Blacks with chronic kidney disease have faster progression to end-stage renal disease than their white counterparts, a Dutch study shows
Starting 15 months after the initiation of pre-dialysis care, black patients were more than two-and-a-half times more likely to need renal replacement therapy (HR 2.87, 95% CI 1.29-6.41), according to Moniek de Goeij, MSc, a PhD student at Leiden University Medical Center in the Netherlands, and colleagues. And black patients had a faster decline (by 0.18 mL/min/1.73 m2 per month) in estimated glomerular filtration rate (eGFR) during the study period, the researchers reported. The results suggest that health care system factors have a less influential role in explaining black-white differences in the progression of chronic kidney disease. "Our results may implicate that black patients with chronic kidney disease should be referred to pre-dialysis care earlier than white patients to assure timely preparation for renal replacement therapy," they wrote. "Fortunately, in the Netherlands this is already the case because our data showed that black patients had a higher eGFR at the start of pre-dialysis care than white patients." U.S. studies have shown that among patients with chronic kidney disease, blacks more rapidly deteriorate to end-stage renal disease than whites.