Prasad Shilpanjali, Singh Seema, Duncan Neill, Cairns Tom D H, Griffith Megan, Hakim Nadey, McLean Adam G, Palmer Andrew, Papalois Vassilios, Taube David
Kidney Int. 2004 Dec;66(6):2416-21. doi: 10.1111/j.1523-1755.2004.66017.x.
Indo-Asian and Afro-Caribbean patients have higher rates of renal failure and requirement for renal replacement therapy than the general population in the UK. Despite this, information regarding survival on dialysis is limited.
The incident hemodialysis population of a large west London renal service was reviewed from 1996 to 2001 (N = 465).
The cohort's ethnic background was Indo-Asian (30.8%), Caucasian (49%), Afro-Caribbean (18.3%), and other (1.9%). Indo-Asians and Afro-Caribbeans were younger than Caucasian patients, with a higher rate of diabetes mellitus. Survival on hemodialysis for Indo-Asians was 97.5% and 81.6% at 1 and 3 years, respectively, compared with 92.7% and 75.2% for Caucasians, and 97.5% and 85.3% for Afro-Caribbeans (P = nonsignificant). Dialysis adequacy was observed to be associated with survival. Patients with mean single pool Kt/V of over 1.4 had survival of 90.6% and 74.8% at 2 and 5 years, respectively, compared with 74.0% and 42.9% for those with Kt/V less than 1.4 (P < 0.001). There were significantly more patients in the Indo-Asian cohort with a mean Kt/V of 1.4 or over (87.4%) compared with Caucasians (57.6%) and Afro-Caribbeans (52.4%), and the benefit of higher Kt/V was seen in all ethnic groups. In a multivariate analysis of factors including Kt/V over 1.4, age, diabetic status, gender, and ethnicity, Indo-Asian or Afro-Caribbean ethnicity did not confer a survival disadvantage. The strongest predictors of survival were age and dialysis adequacy.
Indo-Asian and Afro-Caribbean hemodialysis patients have survival comparable to Caucasians despite a higher burden of diabetes.
与英国普通人群相比，印度裔亚洲人和非洲裔加勒比人肾衰竭及肾脏替代治疗需求的发生率更高。尽管如此，关于透析患者生存率的信息却很有限。
对1996年至2001年伦敦西部一家大型肾脏服务机构的新进入血液透析患者群体进行了回顾性研究（N = 465）。
该队列的种族背景为印度裔亚洲人（30.8%）、白种人（49%）、非洲裔加勒比人（18.3%）和其他（1.9%）。印度裔亚洲人和非洲裔加勒比人比白种人患者年轻，糖尿病发生率更高。印度裔亚洲人血液透析1年和3年的生存率分别为97.5%和81.6%，白种人分别为92.7%和75.2%，非洲裔加勒比人分别为97.5%和85.3%（P = 无显著性差异）。观察到透析充分性与生存率相关。平均单池Kt/V超过1.4的患者2年和5年生存率分别为90.6%和74.8%，而Kt/V低于1.4的患者分别为74.0%和42.9%（P < 0.001）。印度裔亚洲人群体中平均Kt/V为1.4或更高的患者（87.4%）显著多于白种人（57.6%）和非洲裔加勒比人（52.4%），并且在所有种族群体中都观察到了较高Kt/V的益处。在对包括Kt/V超过1.4、年龄、糖尿病状态、性别和种族等因素的多变量分析中，印度裔亚洲或非洲裔加勒比种族并未导致生存劣势。生存的最强预测因素是年龄和透析充分性。
尽管糖尿病负担较重，但印度裔亚洲人和非洲裔加勒比血液透析患者的生存率与白种人相当。
