Photo Credit: Dumitru Ochievschi
The following is a summary of “Role of Age and Competing Risk of Death in the Racial Disparity of Kidney Failure Incidence after Onset of Chronic Kidney Disease,” published in the January 2024 issue of Nephrology by Yan et al.
Researchers started a retrospective study to evaluate racial disparities in kidney failure and mortality among chronic kidney disease (CKD) patients diagnosed using the race-free 2021 CKD-EPI equation, further investigating the influence of baseline factors on these disparities.
They analyzed a nationwide cohort with 547,188 US veterans, of which 103,821 were non-Hispanic Black and 443,367 were non-Hispanic White, aged 18 to 85. The focus was on those with new-onset CKD between 2005 and 2016. The participants were monitored for a decade (May 2018), exploring incidents of kidney failure necessitating kidney replacement therapy (KFRT) and pre-KFRT mortality.
The results showed that, on average, Black veterans were 7.8 years younger than their White counterparts at the onset of CKD. The cumulative incidence of KFRT was 2.5 times higher for Black veterans compared to White veterans during any period following CKD onset. Additionally, Black veterans consistently exhibited more than a 2-fold higher risk of KFRT throughout the follow-up period (overall HR [95% CI], 2.38 [2.31-2.45]) while experiencing 17-48% lower hazards of pre-KFRT death. Adjusting for the racial age difference at CKD onset diminished these discrepancies.
They concluded that younger age at CKD onset among Black adults compared to White adults explained the observed 2.5-fold higher cumulative incidence of kidney failure through a combination of faster CKD progression and lower competing mortality risk.
Source: journals.lww.com/jasn/abstract/9900/role_of_age_and_competing_risk_of_death_in_the.244.aspx