Brandon M. Varilek, Mary J. Isaacson, Hossein Moradi Rekabdarkolaee
{"title":"评估美国印第安人/阿拉斯加原住民糖尿病患者终末期肾病存活率的差异","authors":"Brandon M. Varilek, Mary J. Isaacson, Hossein Moradi Rekabdarkolaee","doi":"10.1007/s40615-024-02173-z","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>American Indian/Alaska Natives (AI/ANs) disproportionately suffer from diabetes compared to non-Hispanic whites (NHW). In 2013, 69% of end-stage kidney disease (ESKD) in AI/ANs was caused by diabetes (ESKD-D) but accounts for only 44% of ESKD diagnoses in the overall USA population. Moreover, the diagnosis of diabetes and ESKD-D may be significantly related to social determinants of health. The purpose of this study was to conduct a survival analysis of AI/ANs and NHWs diagnosed with ESKD-D nationally and by Indian Health Service region and correlate the survival analysis to the Area Deprivation Index® (ADI®).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This manuscript reports a retrospective cohort analysis of 2021 United States Renal Data System data. Eligible patient records were AI/AN and NHWs with diabetes as the primary cause of ESKD and started dialysis on January 1, 2014, or later.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 81,862 patient records were included in this analysis, of which 1798 (2.2%) were AI/AN. AI/ANs survive longer, with an 18.4% decrease in risk of death compared to NHW. However, AI/ANs are diagnosed with ESKD-D and start dialysis earlier than NHWs. ADI® variables became significant as ADI® ratings increased, meaning persons with greater social disadvantage had worse survival outcomes.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The findings reveal that AI/ANs have better survival outcomes than NWH, explained in part by initiating dialysis earlier than NHW. Additional research is needed to explore factors (e.g., social determinants; cultural; physiologic) that contribute to earlier diagnosis of ESKD-D in AI/ANs and the impact of prolonged dialysis on quality of life of those with ESKD-D.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating Disparities in End-Stage Kidney Disease Survival Among American Indian/Alaska Native Persons with Diabetes\",\"authors\":\"Brandon M. Varilek, Mary J. Isaacson, Hossein Moradi Rekabdarkolaee\",\"doi\":\"10.1007/s40615-024-02173-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background</h3><p>American Indian/Alaska Natives (AI/ANs) disproportionately suffer from diabetes compared to non-Hispanic whites (NHW). In 2013, 69% of end-stage kidney disease (ESKD) in AI/ANs was caused by diabetes (ESKD-D) but accounts for only 44% of ESKD diagnoses in the overall USA population. Moreover, the diagnosis of diabetes and ESKD-D may be significantly related to social determinants of health. The purpose of this study was to conduct a survival analysis of AI/ANs and NHWs diagnosed with ESKD-D nationally and by Indian Health Service region and correlate the survival analysis to the Area Deprivation Index® (ADI®).</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>This manuscript reports a retrospective cohort analysis of 2021 United States Renal Data System data. Eligible patient records were AI/AN and NHWs with diabetes as the primary cause of ESKD and started dialysis on January 1, 2014, or later.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>A total of 81,862 patient records were included in this analysis, of which 1798 (2.2%) were AI/AN. AI/ANs survive longer, with an 18.4% decrease in risk of death compared to NHW. However, AI/ANs are diagnosed with ESKD-D and start dialysis earlier than NHWs. ADI® variables became significant as ADI® ratings increased, meaning persons with greater social disadvantage had worse survival outcomes.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>The findings reveal that AI/ANs have better survival outcomes than NWH, explained in part by initiating dialysis earlier than NHW. Additional research is needed to explore factors (e.g., social determinants; cultural; physiologic) that contribute to earlier diagnosis of ESKD-D in AI/ANs and the impact of prolonged dialysis on quality of life of those with ESKD-D.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40615-024-02173-z\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40615-024-02173-z","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Evaluating Disparities in End-Stage Kidney Disease Survival Among American Indian/Alaska Native Persons with Diabetes
Background
American Indian/Alaska Natives (AI/ANs) disproportionately suffer from diabetes compared to non-Hispanic whites (NHW). In 2013, 69% of end-stage kidney disease (ESKD) in AI/ANs was caused by diabetes (ESKD-D) but accounts for only 44% of ESKD diagnoses in the overall USA population. Moreover, the diagnosis of diabetes and ESKD-D may be significantly related to social determinants of health. The purpose of this study was to conduct a survival analysis of AI/ANs and NHWs diagnosed with ESKD-D nationally and by Indian Health Service region and correlate the survival analysis to the Area Deprivation Index® (ADI®).
Methods
This manuscript reports a retrospective cohort analysis of 2021 United States Renal Data System data. Eligible patient records were AI/AN and NHWs with diabetes as the primary cause of ESKD and started dialysis on January 1, 2014, or later.
Results
A total of 81,862 patient records were included in this analysis, of which 1798 (2.2%) were AI/AN. AI/ANs survive longer, with an 18.4% decrease in risk of death compared to NHW. However, AI/ANs are diagnosed with ESKD-D and start dialysis earlier than NHWs. ADI® variables became significant as ADI® ratings increased, meaning persons with greater social disadvantage had worse survival outcomes.
Conclusions
The findings reveal that AI/ANs have better survival outcomes than NWH, explained in part by initiating dialysis earlier than NHW. Additional research is needed to explore factors (e.g., social determinants; cultural; physiologic) that contribute to earlier diagnosis of ESKD-D in AI/ANs and the impact of prolonged dialysis on quality of life of those with ESKD-D.
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