TY - JOUR
T1 - Race-dependent survival disparity on hemodialysis
T2 - Any role for high serum aluminum levels in higher Caucasian mortality?
AU - Deogaygay, B.
AU - Fleischmann, E.
AU - Bower, J. D.
AU - Salahudeen, A. K.
PY - 1999/2
Y1 - 1999/2
N2 - The mortality rate on hemodialysis remains unacceptably high, and it is worse in Caucasian than in Afro-Americans. Defining factors that influence the survival disparity may help to develop strategy to improve survival for dialysis population at large. We compared one-year survival of 145 Caucasian with age and sex matched 685 Afro-American patients on hemodialysis. The predictive variables for survival in Caucasians and Afro-Americans were determined separately by Univariate Cox proportional hazard analysis, and variables that were significant were further analyzed using the multivariate format. By actuarial analysis, one-year survival was significantly higher in Afro-Americans than in Caucasians (p<0.001). In univariate analysis, serum albumin, pre-albumin and creatinine had positive influence, whereas age and diabetes had negative influence on both Caucasians' and Afro-Americans' survival. In Caucasians, unlike the Afro-Americans, male gender, underweight, and serum aluminum levels had significant negative influence on survival. Serum aluminum levels were higher in Caucasians compared to Afro-Americans (14.3±0.6 vs. 20±2.3 mcg/ml; m±SE, p=0.0009), and the slight but significant negative impact of serum aluminum on survival (RR 1.012, 1.003-1.021% CI, p<0.007) persisted in multivariate analysis after adjustment for age, gender, albumin, creatinine and BMI. Our data suggest that higher death rate in Caucasian compared to Afro-Americans is associated with higher prevalence of underweight and higher levels of serum aluminum. Further studies are required to verify the significance of our cross-sectional findings.
AB - The mortality rate on hemodialysis remains unacceptably high, and it is worse in Caucasian than in Afro-Americans. Defining factors that influence the survival disparity may help to develop strategy to improve survival for dialysis population at large. We compared one-year survival of 145 Caucasian with age and sex matched 685 Afro-American patients on hemodialysis. The predictive variables for survival in Caucasians and Afro-Americans were determined separately by Univariate Cox proportional hazard analysis, and variables that were significant were further analyzed using the multivariate format. By actuarial analysis, one-year survival was significantly higher in Afro-Americans than in Caucasians (p<0.001). In univariate analysis, serum albumin, pre-albumin and creatinine had positive influence, whereas age and diabetes had negative influence on both Caucasians' and Afro-Americans' survival. In Caucasians, unlike the Afro-Americans, male gender, underweight, and serum aluminum levels had significant negative influence on survival. Serum aluminum levels were higher in Caucasians compared to Afro-Americans (14.3±0.6 vs. 20±2.3 mcg/ml; m±SE, p=0.0009), and the slight but significant negative impact of serum aluminum on survival (RR 1.012, 1.003-1.021% CI, p<0.007) persisted in multivariate analysis after adjustment for age, gender, albumin, creatinine and BMI. Our data suggest that higher death rate in Caucasian compared to Afro-Americans is associated with higher prevalence of underweight and higher levels of serum aluminum. Further studies are required to verify the significance of our cross-sectional findings.
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M3 - Article
AN - SCOPUS:33750113609
SN - 1708-8267
VL - 47
SP - 121A
JO - Journal of Investigative Medicine
JF - Journal of Investigative Medicine
IS - 2
ER -