不同地理居住地的亚洲人、夏威夷原住民和其他太平洋岛民终末期肾病结果的种族差异。

IF 4.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
American Journal of Nephrology Pub Date : 2024-01-01 Epub Date: 2023-09-19 DOI:10.1159/000534052
Amy S You, Keith C Norris, Merle Kataoka-Yahiro, James Davis, Victoria Page, Glen Hayashida, Yoko Narasaki, Shiuh Feng Cheng, Roland Ng, Linda L Wong, Lung-Yi Lee, Kamyar Kalantar-Zadeh, Connie M Rhee
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引用次数: 0

摘要

引言:虽然亚洲人、夏威夷原住民和其他太平洋岛民(NHOPI)的肾病风险因素患病率很高,但很少有数据检查他们的终末期肾病(ESKD)结果。由于夏威夷有大量亚洲人和非霍奇金淋巴瘤患者,我们根据居住在美国大陆和夏威夷/太平洋岛屿(PI)的情况比较了他们的ESKD结果。材料和方法:使用美国肾脏数据系统的数据,我们检查了居住在大陆和太平洋岛屿的地理影响。夏威夷/PI对2000年1月1日至2016年12月31日期间转换为透析的ESKD患者种族死亡率相关性的Cox回归分析。我们使用Cox模型和累积发病率曲线检查了透析后肾移植的可能性。结果:与大陆的白人患者相比,亚洲人和大陆的NHOPI患者的死亡率较低:调整后的HR(aHR)(95%CI)分别为0.67(0.66-0.67)和0.72(0.70-0.73)。在夏威夷/PI检查亚洲人和非霍奇金淋巴瘤时,亚洲人的生存益处减弱,非霍奇金淋巴瘤的生存益处降至零(参考:大陆白人患者)。比较亚洲人、非霍奇金淋巴瘤和白人患者的累积发病率曲线显示,大陆的亚洲人和非霍奇金淋巴瘤移植的可能性最高,而夏威夷/PI的非霍奇金淋巴瘤患者和亚洲人移植的可能性最低。讨论/结论:在大陆,亚洲人和非霍奇金淋巴瘤患者的死亡率比白人患者低,而在夏威夷/PI,亚洲人的生存益处降低,非霍奇金淋巴瘤的生存益处减轻。夏威夷/PI的NHOPI和亚洲人的移植比大陆的少。需要进一步的研究来揭示在不同地理居住地的亚洲人和非霍奇金淋巴瘤患者中导致ESKD结果差异的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Racial Disparities in End-Stage Kidney Disease Outcomes among Asians and Native Hawaiians and Other Pacific Islanders across Geographic Residence.

Introduction: While Asian and Native Hawaiian and other Pacific Islander (NHOPI) patients have a high prevalence of kidney disease risk factors, there are sparse data examining their end-stage kidney disease (ESKD) outcomes. As Hawaii has high representation of Asian and NHOPI individuals, we compared their ESKD outcomes based on residence in the mainland USA versus Hawaii/Pacific Islands (PIs).

Materials and methods: Using United States Renal Data System data, we examined the impact of geographic residence in the mainland versus Hawaii/PIs on race-mortality associations among incident ESKD patients transitioning to dialysis over January 1, 2000-December 31, 2016 using Cox regression. We examined likelihood of post-dialysis kidney transplantation using Cox models and cumulative incidence curves.

Results: Compared with White patients in the mainland, Asian and NHOPI patients in the mainland had lower mortality: adjusted HRs (95% CIs) 0.67 (0.66-0.67) and 0.72 (0.70-0.73), respectively. When examining Asian and NHOPI patients in Hawaii/PIs, survival benefit was attenuated in Asian and diminished to the null in NHOPI patients (ref: mainland White patients). Cumulative incidence curves comparing Asian, NHOPI, and White patients showed Asian and NHOPI patients in the mainland had the highest likelihood of transplantation, whereas NHOPI and Asian patients in Hawaii/PIs had the lowest likelihood.

Conclusion: In the mainland, Asian and NHOPI patients had lower mortality versus White patients, whereas in Hawaii/PIs, this survival benefit was diminished in Asian and mitigated in NHOPI patients. NHOPI and Asian patients in Hawaii/PIs had less transplantation versus those in the mainland. Further research is needed to uncover factors contributing to differential ESKD outcomes among Asian and NHOPI patients across geographic residence.

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来源期刊
American Journal of Nephrology
American Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
7.50
自引率
2.40%
发文量
74
审稿时长
4-8 weeks
期刊介绍: The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including:
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