Black veterans with new-onset CKD have higher cumulative incidence of kidney failure
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Key takeaways:
- Black veterans had a 2.5-fold higher cumulative incidence of kidney failure vs. white veterans.
- Black veterans were 7.8 years younger than white veterans at the onset of CKD.
Black veterans with new-onset chronic kidney disease had a 2.5-fold higher cumulative incidence of kidney failure compared with white veterans, according to a published study.
“Previous studies that examined the racial difference in kidney failure have been limited by the use of prevalent populations and outdated GFR estimating equations, both of which can induce bias,” Guofen Yan, PhD, of the department of public health sciences at the University of Virginia School of Medicine, wrote with colleagues. “Moreover, racial differences in risk factors at the time of CKD onset may contribute to the subsequent racial difference in developing kidney failure, but this has not been well studied.”
In a national cohort study of 547,188 U.S. veterans with new-onset CKD, researchers assessed racial differences in kidney failure and death from using the race-free 2021 CKD Epidemiology Collaboration equation. Of the patients, aged 18 to 85 years, 103,821 identified as “non-Hispanic Black” and 443,367 were “non-Hispanic white.”
Veterans in the study had new-onset CKD between 2005 and 2016 and were followed for 10 years for incident kidney failure with replacement therapy (KFRT) and pre-KFRT death.
Researchers examined whether factors at the time of onset could explain racial disparities.
Black veterans had a 2.5-fold higher cumulative incidence of kidney failure vs. their white counterparts during any follow-up period from the onset of CKD, the findings indicated. Yan and colleagues found these patients had persistently greater than twofold higher KFRT hazards through follow-up, while facing decreased risks of pre-KFRT death between 17% to 48%. The differences were reduced when accounting for the racial age gap. On average, Black veterans were 7.8 years younger than white veterans at the onset of CKD.
Disparities were attributed to a combination of higher progression rates to kidney failure and lower rates of competing-risk death in Black veterans, they wrote, “both of which can be largely explained by the younger age at CKD onset in Black compared with white adults.”
The findings “underscore the need to prevent early onset and slow progression of CKD in younger Black adults to reduce the persistent racial disparity in KFRT in the United States.”
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