Leggat J E, Swartz R D, Port F K
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
Adv Ren Replace Ther. 1997 Jan;4(1):22-9. doi: 10.1016/s1073-4449(97)70013-x.
Withdrawal from dialysis has been shown to be a common occurrence in treated end-stage renal disease. Interestingly, there have been several reports documenting that blacks withdraw from dialysis one half to one third the rate of whites. There has been little research into the reasons for this marked discrepancy. This article reviews the existing literature on the different rates of withdrawal in blacks compared with whites. It then draws on a broad range of literature, including sociology, psychiatry, and anthropology, to propose possible reasons for the differences. From this review, it would seem that both medical and cultural factors play important roles in the decisions about withdrawal, but that cultural beliefs and attitudes are more important. More research is needed in both the medical and cultural aspects of rates of withdrawal to help explain the observed differences in blacks compared with whites.
在接受治疗的终末期肾病患者中，停止透析已被证明是一种常见现象。有趣的是，有几份报告记录显示，黑人停止透析的比例仅为白人的二分之一至三分之一。对于这种显著差异的原因，目前研究较少。本文回顾了关于黑人和白人不同透析退出率的现有文献。然后借鉴了包括社会学、精神病学和人类学在内的广泛文献，提出造成这些差异的可能原因。从这篇综述来看，医学因素和文化因素在停止透析的决策中似乎都起着重要作用，但文化信仰和态度更为重要。在透析退出率的医学和文化方面都需要进行更多研究，以帮助解释观察到的黑人和白人之间的差异。
