Evidence map›Paper›PMID 27534603›Full record

ArticleHemodialysis international. International Symposium on Home Hemodialysis2017

Younger black patients have a higher risk of infection mortality that is mostly non-dialysis related: A national study of cause-specific mortality among U.S. maintenance dialysis patients.

Alison J Yu, Keith C Norris, Alfred K Cheung, Guofen Yan

Open access · greenAbstract read
In one paragraph

Article in Hemodialysis international. International Symposium on Home Hemodialysis, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 2 countries.

Alison J YuKeck School of Medicine, University of Southern California, Los Angeles, California, USA.
Keith C NorrisDepartment of Medicine, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
Alfred K CheungDivision of Nephrology & Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Guofen YanDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Central South University · CNUniversity of California, Los Angeles · USUniversity of Southern California · USUniversity of Virginia · US

Funding

UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
The Center for Health Improvement of Minority ElderlyP30AG021684 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Homero Erwin del Pino · 2002 to 2026
$19.7M
TRAINING COREP20MD000182 · NIMHD · CHARLES R. DREW UNIVERSITY OF MED &SCI · PI HARAWA, NINA THAWATA, SHAPIRO, MARTIN F. · 2002 to 2016
$16.5M
Racial Disparity in Quality of Clinical Care in End Stage Renal DiseaseR01DK084200 · NIDDK · UNIVERSITY OF VIRGINIA · PI YAN, GUOFEN · 2010 to 2013
$912k
NCATS NIH HHS UL1 TR000124NIA NIH HHS P30 AG021684NIDDK NIH HHS R01 DK084200NIMHD NIH HHS P20 MD000182
6 · The paper itself

Abstract

introductionWhile it has been well documented that in the U.S., black and Hispanic dialysis patients have overall lower risks of death than white dialysis patients, little is known whether their lower risks are observed in cause-specific deaths. Additionally, recent research reported that younger black patients have a higher risk of death, but the source is unclear. Therefore, this study examined cause-specific deaths among US dialysis patients by race/ethnicity and age.

methodsThis national study included 1,255,640 incident dialysis patients between 1995 and 2010 in the United States Renal Data System. Five cause-specific mortality rates, including cardiovascular (CVD), infection, malignancy, other known causes (miscellaneous), and unknown, were compared across blacks, Hispanics, and whites overall and stratified by age groups.

findingsAfter multiple adjustments, Hispanic patients had the lowest risk of mortality for every major cause in almost all ages. Compared with whites, blacks had a lower risk of death from CVD, malignancy and miscellaneous causes in most age groups, but not from infection. In fact, blacks had a higher risk of infection death than whites in ages 18-30 years (HR [95% CI] 1.94 [1.69-2.23]; P < 0.001), 31-40 years (HR 1.51 [1.40-1.63]; P < 0.001) and 41-50 years (HR 1.07 [1.02-1.12]; P = 0.009), which were partially attributed to their higher prevalence of AIDS nephropathy. For each race/ethnicity, more than two-thirds of infection deaths were due to non-dialysis related infections. DISCUSSION: Hispanics had the lowest risk for each major cause of death. Blacks were less likely to die than whites from most causes, except infection. The previously reported higher overall mortality rate for younger blacks is attributed to their two-fold higher infection mortality, which is mostly non-dialysis related, suggesting a new direction to improve their overall health status. Research is greatly needed to determine social and biological factors that account for the survival gap in dialysis among different racial/ethnic groups.

Indexed as

AdolescentAdultAgedAged, 80 and overBlack or African AmericanFemaleFluid TherapyHumansMaleMiddle AgedRenal DialysisSurvival AnalysisTreatment OutcomeUnited StatesYoung AdultCardiovasculardialysis related infectionnon-dialysis related infectionracial/ethnic differencesUSRDS

Identifiers

PMID27534603
PMCPMC5316377
OpenAlexW2513479561

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.