Price D A, Owen W F
Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Adv Ren Replace Ther. 1997 Jan;4(1):3-12. doi: 10.1016/s1073-4449(97)70011-6.
African-Americans are the fasting growing racial minority with end stage renal disease (ESRD) in the United States. Currently, African-Americans comprise approximately 31% of the ESRD population. African-Americans are almost a decade younger than their white (referring to non-Hispanic white) counterparts with ESRD with a mean age of 58 years old. Although African-Americans systematically receive less dialysis than whites (Kt/V of 1.05 versus 1.18, respectively), their survival is higher. The 2-year survival probability of African-Americans is 66.2% in comparison with 59.8% for whites. This improved survival with ESRD is accompanied by an improved quality of life for African-Americans. Their enhanced quality of life is reflected by a greatly decreased frequency of withdrawing from dialysis treatments. In this article, we will examine the reasons why African-Americans have an excessive incidence of selective diseases that culminate in ESRD. We will explore the factors that influence the difference in dialysis modality selection between African-Americans and whites. Lastly, we will pose and judge several hypotheses that may account for the improved survival enjoyed by African-Americans with ESRD. We contend that research to clarify the basis for these differences between African-Americans and whites with ESRD will improve outcomes for both populations and is fiscally sound health policy.
非裔美国人是美国终末期肾病（ESRD）患者中增长最快的少数族裔。目前，非裔美国人约占ESRD患者总数的31%。非裔美国人患ESRD的年龄比白人（指非西班牙裔白人）小近十岁，平均年龄为58岁。尽管非裔美国人接受透析治疗的次数总体上比白人少（Kt/V分别为1.05和1.18），但其生存率更高。非裔美国人的两年生存概率为66.2%，而白人为59.8%。非裔美国人ESRD患者生存率的提高伴随着生活质量的改善。他们生活质量的提高体现在停止透析治疗的频率大幅降低。在本文中，我们将探讨非裔美国人患导致ESRD的选择性疾病发病率过高的原因。我们将探究影响非裔美国人和白人在透析方式选择上存在差异的因素。最后，我们将提出并评判几个可能解释非裔美国人ESRD患者生存率提高的假设。我们认为，开展研究以阐明非裔美国人和白人ESRD患者之间这些差异的根源，将改善这两个人群的治疗效果，并且是一项经济上合理的卫生政策。
