Impact of Race on Survival in Hemodialysis Patients
Author Information
Author(s): Kamyar Kalantar-Zadeh, Jessica E Miller, Csaba P Kovesdy, Rajnish Mehrotra, Lilia R Lukowsky, Elani Streja, Joni Ricks, Jennie Jing, Allen R Nissenson, Sander Greenland, Keith C Norris
Primary Institution: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Hypothesis
Mineral and bone disorders (MBDs) have a bearing on survival advantages of black hemodialysis patients.
Conclusion
African Americans who received higher doses of paricalcitol had a demonstrable survival advantage compared to those who received lower doses or no active vitamin D.
Supporting Evidence
- Blacks have higher serum calcium and parathyroid hormone levels than nonblacks.
- Blacks are more likely to receive higher doses of injectable active vitamin D.
- Survival advantages of blacks appear restricted to those receiving higher doses of active vitamin D.
Takeaway
This study found that black patients on dialysis tend to live longer if they get higher doses of a vitamin D treatment.
Methodology
Data from 139,328 hemodialysis patients were analyzed over 5 years, focusing on racial differences in mineral and bone disorders and survival.
Potential Biases
Potential bias due to lack of detailed data on comorbid states and laboratory markers of inflammation.
Limitations
The study lacked access to data on oral medications related to mineral and bone disorders.
Participant Demographics
32% of participants were African Americans, with a mix of genders and ages.
Statistical Information
P-Value
0.87
Confidence Interval
0.83–0.91
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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