Ethnicity and survival on dialysis in west London

Prasad, Shilpanjali; Singh, Seema; Duncan, Neill; Cairns, Tom; Griffith, Megan; Hakim, Nadey; McLean, A.G.; Palmer, Andrew J.; Papalois, Vassilios; Taube, David

doi:10.1111/j.1523-1755.2004.66017.x

Cited by 13 publications

(11 citation statements)

References 15 publications

(11 reference statements)

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“…Our study showed that Caucasoid patients had significantly inferior survival compared to other ethnicities, consistent with other similar UK studies [18]. This trend for increased mortality in Caucasoids has also been demonstrated in the USA where socioeconomic and nutritional factors would be expected to have greater influence [19], and Wolf et al [20] hypothesised that higher use of activated vitamin D sterols in non-Caucasoids may offer a survival advantage.…”

Section: Discussionsupporting

confidence: 80%

“…This trend for increased mortality in Caucasoids has also been demonstrated in the USA where socioeconomic and nutritional factors would be expected to have greater influence [19], and Wolf et al [20] hypothesised that higher use of activated vitamin D sterols in non-Caucasoids may offer a survival advantage. That aside, it remains unclear as to why ethnic minorities have a survival advantage, although more elderly Caucasoids have underlying generalised atherosclerotic disease [18]. …”

Section: Discussionmentioning

confidence: 99%

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Is Dialysis a Viable Option for the Older Patient? Outcomes for Patients Starting Dialysis Aged 80 Years or Older

Isaacs¹,

Burns²,

Davenport³

2012

Blood Purif

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Background: Maximum conservative management (MCM) has been proposed as an alternative care pathway for the increasing number of elderly patients with progressive chronic kidney disease. Methods: Retrospective analysis of patients aged ≥80 years of age, starting dialysis between 2000 and 2009 in a centre with an established MCM programme. Demographic data, baseline biochemical markers and survival were collected. Results: 93 consecutive patients were studied; median age 83 years (IQR 81–86). 67 male, 32% diabetic. Median survival 46.5 months (range 0–107), with 1- and 5-year survival 78.5 and 38.3%, respectively. Factors predicting poorer survival were Caucasoid ethnicity (p = 0.04) and serum albumin ≤30 g/l (p = 0.01) at dialysis initiation. Duration of nephrology care prior to dialysis initiation did not effect survival. Conclusion: The very elderly electing dialysis were found to have good survival. Further patient characterisation is required to improve decision-making between dialysis and MCM for elderly patients with progressive chronic kidney disease.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Is Dialysis a Viable Option for the Older Patient? Outcomes for Patients Starting Dialysis Aged 80 Years or Older

Isaacs¹,

Burns²,

Davenport³

2012

Blood Purif

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“…No survival analysis reported due to small sample size. Relevant confounders were collected and included in analysis.Male: 44Female: 37Age 10-79Prasad, 2004 [46]Cohort study465Afro-Caribbean vs. South Asians vs. WhitesUnited KingdomClinic or hospital based studyNo limitation stated. Statistical methods vaguely described.Male: 288Female: 177DM unspecifiedRiste, 2001 [47]Cross-sectional study1,022Afro-Caribbean vs.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies investigated disparities in micro-vascular and macro-vascular complications among persons with diabetes [13,14,19,24,27,33,34,37,39,40,45,46,48]. The micro-vascular complications included retinopathy, nephropathy as well as peripheral sensory neuropathy or was not individually specified in the papers reviewed.…”

Section: Resultsmentioning

confidence: 99%

Disparities in diabetes mellitus among Caribbean populations: a scoping review

Bennett

Francis

Ferguson

et al. 2015

Int J Equity Health

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BackgroundDespite the large body of research on racial/ethnic disparities in health, there are limited data on health disparities in Caribbean origin populations. This review aims to analyze and synthesize published literature on the disparities in diabetes mellitus (DM) and its complications among Afro-Caribbean populations.MethodsA detailed protocol, including a comprehensive search strategy, was developed and used to identify potentially relevant studies. Identified studies were then screened for eligibility using pre-specified inclusion and exclusion criteria. An extraction form was developed to chart data and collate study characteristics including methods and main findings. Charted information was tagged by disparity indicators and thematic analysis performed. Disparity indicators evaluated include ethnicity, sex, age, socioeconomic status, disability and geographic location. Gaps in the literature were identified and extrapolated into a gap map.ResultsA total of 1009 diabetes related articles/manuscripts, published between 1972 and 2013, were identified and screened. Forty-three studies met inclusion criteria for detailed analysis. Most studies were conducted in the United Kingdom, Trinidad and Tobago and Jamaica, and used a cross-sectional study design. Overall, studies reported a higher prevalence of DM among Caribbean Blacks compared to West African Blacks and Caucasians but lower when compared to South Asian origin groups. Morbidity from diabetes-related complications was highest in persons with low socioeconomic status. Gap analysis showed limited research data reporting diabetes incidence by sex and socioeconomic status. No published literature was found on disability status or sexual orientation as it relates to diabetes burden or complications. Prevalence and morbidity were the most frequently reported outcomes.ConclusionLiterature on diabetes health disparities in Caribbean origin populations is limited. Future research should address these knowledge gaps and develop approaches to reduce them.

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“…It is however encouraging that studies conducted in both the UK and the United States report that survival rates in ESRD are not compromised due to ethnicity. In fact, several studies have reported better survival rates in South Asian dialysis patients [31, 32, 33, 34]. Although the determinants of better survival in South Asians are not fully understood, factors such as higher mean Kt/V have been associated with more favourable outcomes [34].…”

Section: Prevalence Of Esrd In South Asiansmentioning

confidence: 99%

Identifying Depression in South Asian Patients with End-Stage Renal Disease: Considerations for Practice

Sharma

Bhui²,

Chilcot³

et al. 2011

Nephron Extra

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Depression is a prevalent burden for patients with end-stage renal disease (ESRD) and one that is under-recognized and consequently under-treated. Although several studies have explored the association between depression symptoms, treatment adherence and outcomes in Euro-American patient groups, quantitative and qualitative exploration of these issues in patients from different cultural and ethnic backgrounds has been lacking. This review discusses the methodological issues associated with measuring depression in patients of South Asian origin who have a 3- to 5-fold greater risk of developing ESRD. There is a need to advance research into the development of accurate screening practices for this patient group, with an emphasis on studies utilizing rigorous approaches to evaluating the use of both emic (culture-specific) and etic (universal or culture-general) screening instruments.

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Ethnicity and survival on dialysis in west London

Abstract: Indo-Asian and Afro-Caribbean hemodialysis patients have survival comparable to Caucasians despite a higher burden of diabetes.

Cited by 13 publications

References 15 publications

Is Dialysis a Viable Option for the Older Patient? Outcomes for Patients Starting Dialysis Aged 80 Years or Older

Is Dialysis a Viable Option for the Older Patient? Outcomes for Patients Starting Dialysis Aged 80 Years or Older

Disparities in diabetes mellitus among Caribbean populations: a scoping review

Identifying Depression in South Asian Patients with End-Stage Renal Disease: Considerations for Practice

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