African Americans with early-stage CKD have higher death risk than whites

LOS ANGELES—African-American patients with early stages of chronic kidney disease have a higher risk of death than white patients at the same stage of disease, according to a study to be published in July’s Journal of the American Society of Nephrology.

African Americans younger than 65 years old with early-stage kidney disease have a 78 percent higher death risk than white patients, according to the study’s lead researcher Rajnish Mehrotra, MD, who is with the nonprofit research institution LA BioMed.

In their background research, the Mehrotra and his team found that African Americans, in general, have higher mortality rates than whites. However, African Americans with late-stage CKD, they found, had a survival advantage over whites. Hispanic patients with late-stage CKD also had a survival advantage over whites.

To better understand this trend, the researchers looked into data from 14,611 patients in the Third National Health and Nutrition Examination Survey (NHANES), which is a population-based survey of the United States.

In that group, 2,892 people had CKD, and 1,127 of them died during follow-up. Furthermore, for those with early-stage disease younger than 65 years old, the researchers found African Americans had a 78 percent higher risk of death compared to whites.

“Our findings indicate the socio-economic factors of poverty, a lack of insurance and lower education rates may contribute to these higher death rates among blacks,” Mehrotra said. “Addressing these factors could improve survival rates for blacks in the early stages of kidney disease.”

Because of the higher death risk in the early stages of CKD, healthier African Americans are surviving and developing later stages of CKD, which might help explain the lower mortality rates if African Americans with advanced CKD, according to the researchers.

“These data suggest that factors such as education, poverty and lower probability of medical insurance may be more important in mediating the high risk for death among younger black individuals than are biologic differences,” the authors wrote. “This, in turn, may help in prioritizing interventions aimed at reducing disparities among young black individuals with chronic kidney disease.”