Race Not a Factor in Progression to ESRD, Death

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LAS VEGAS—Race does not appear to affect the likelihood of progression to end-stage renal disease and overall mortality among obese individuals with chronic kidney disease (CKD), a study found.

The study also showed that older age, male gender, and diabetes predict higher rates of ESRD. Older age, male gender, diabetes, and higher body mass index (BMI) predict an increased risk of overall mortality.

“Our findings add to the growing body of literature on racial differences in CKD as well as the ongoing discussion on the importance of addressing obesity as a risk factor in CKD,” the investigators concluded.

These findings, by Revekka Babayev, MD, of Columbia University in New York, and collaborators emerged from a study of 6,409 obese individuals with CKD stages 3-4 who participated in the National Kidney Foundation's Kidney Early Evaluation Program. Of these, 34% were African American and 66% were white.

African Americans had a higher baseline rate of secondary hyperparathyroidism (63.1% vs. 47.7%), a higher baseline mean estimated glomerular filtration rate (49 vs. 46.5 mL/min/1.73 m2), and a greater degree of anemia (mean hemoglobin 12.7 vs. 13.5 g/dL). African Americans also had a greater prevalence of micro- and macroalbuminuria as well as hypertension and family history of kidney disease.

Each one-year increment in age was associated with a 4% increased risk of overall mortality. Male gender was associated with a 57% increased risk of ESRD and 54% increased risk of overall mortality compared with female gender. The presence of diabetes increased the risk of ESRD and overall mortality fourfold and twofold, respectively. Each 1-unit increment in BMI was associated with a 6% increased risk of overall mortality.

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