Association of Race and Age With Survival Among Patients Undergoing Dialysis

Abstract

Blacks are significantly overrepresented in the end-stage renal disease (ESRD) population. Of more than 500 000 individuals with ESRD in the United States, approximately one-third are black, and the relative incidence of ESRD is 3.6 times higher among black than white patients.¹ Moreover, racial disparities in quality of and access to care for patients with kidney disease are well-documented.^2-4 Compared with white patients, fewer black patients with chronic kidney disease (CKD) are under the care of a nephrologist, and their rates of referral for peritoneal dialysis and kidney transplantation are significantly lower.^5,6 Black patients who receive dialysis are less likely to receive an adequate dialysis dose,^7,8 have a fistula placed,^9,10 and achieve target hemoglobin levels—all metrics associated with decreased dialysis survival.¹¹