重新评估种族对透析患者生存的影响。
Reappraisal of the impact of race on survival in patients on dialysis.
机构信息
Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1053, USA.
出版信息
Am J Kidney Dis. 2010 Jun;55(6):1102-10. doi: 10.1053/j.ajkd.2009.10.062.
Abstract
Racial differences in the cause, natural history, and effects of chronic kidney disease have long been the subject of investigation. Dialysis-dependent kidney failure occurs nearly 4 times more often in African Americans than European Americans. Despite this observation, studies repeatedly show that African Americans have a significant survival advantage after initiating dialysis therapy. Although this phenomenon has been attributed to environmental and socioeconomic factors, recent studies show that inherited factors strongly influence racial differences in the development of diverse kidney diseases and may affect the risk of nephropathy-associated cardiovascular disease. We review relevant studies and propose the hypothesis that inherited factors leading to organ-limited kidney diseases and a lower burden of systemic atherosclerosis contribute in part to the improved survival rates in African American patients on dialysis therapy.
摘要
种族差异在慢性肾脏病的病因、自然病程和影响方面一直是研究的主题。依赖透析的肾衰竭在非裔美国人中发生的频率比欧洲裔美国人高近 4 倍。尽管有这一观察结果，但研究反复表明，在开始透析治疗后，非裔美国人具有显著的生存优势。尽管这种现象归因于环境和社会经济因素，但最近的研究表明，遗传因素强烈影响不同肾脏疾病的种族差异，并可能影响与肾病相关的心血管疾病的风险。我们回顾了相关研究，并提出了一个假设，即导致器官局限性肾脏疾病和全身性动脉粥样硬化负担较低的遗传因素部分导致了接受透析治疗的非裔美国患者的生存率提高。
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