Study: Faster kidney function decline in Black, Hispanic patients doubles ESKD risk
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Study findings suggest Black and Hispanic patients are at greater risk for developing kidney failure due to faster decline in kidney function following chronic kidney disease onset vs. white patients.
The data were presented at the virtual ASN Kidney Week.
“In the U.S., Blacks and Hispanics have higher incidence of ESKD than whites,” Guofen Yan, PhD, of the University of Virginia, and colleagues wrote in a poster. “Whether this is driven by lower mortality prior to [end-stage kidney disease] ESKD or inherently faster progression to ESKD has not been clearly determined because most studies used prevalent cohorts that created survival bias. We examined this issue using a newly constructed national cohort of patients with new-onset CKD.”
Including 834,270 individuals from the U.S. Veterans Health Administration, Yan and colleagues compared cause-specific hazards ratios for two competing events 10 years after CKD onset: the occurrence of ESKD and pre-ESKD mortality.
Researchers noted all participants, regardless of race/ethnicity, had similar baseline eGFRs.
After 10 years, results showed the fractions of patients who progressed to ESKD were 1.3 to 2.5 times greater for Black and Hispanic patients vs. whites across six age groups. In addition, researchers observed cause-specific hazards for ESKD were 2.1 to 2.9 times greater for Black patients and 1.2 to 2.7 times greater for Hispanic patients, with cause-specific hazards for pre-ESKD mortality determined to be similar for Black patients and “only modestly lower” for Hispanic patients vs. white patients across age groups.
In a related press release, Yan commented on the findings.
“Following CKD onset, Blacks and Hispanics were [two] times more likely than whites to develop kidney failure, and this was truly driven by a greater risk of kidney failure due to faster decline in kidney function after CKD onset, rather than because of lower risks of death prior to kidney failure,” she concluded, adding it is necessary to further examine and eliminate the causes of faster kidney function decline in these patients to improve clinical outcomes following CKD diagnosis.
“Slowing the faster progression in Blacks and Hispanics with CKD should be a major focus in research, practice and health care policy to achieve the goal of reducing the disparities in CKD,” she said.
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Yan G, et al. Paper FR-OR15. Presented at: ASN Kidney Week. Oct. 22-25, 2020 (virtual meeting).
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