Young Black Patients on Dialysis Do Worse Than White Counterparts

Stephanie Desmon, Johns Hopkins Medicine, August 15, 2011

For years, medical studies have reached the same conclusion: African-American patients do better on kidney dialysis than their white counterparts. But new Johns Hopkins research, published Aug. 10 in the Journal of the American Medical Association, shows that younger blacks–those under the age of 50–actually do much worse on dialysis than equally sick whites who undergo the same blood-filtering process.

The findings, called “surprising” by the research team, could have a serious impact on long-held practices guiding who gets referred for lifesaving kidney transplantation and who remains on dialysis indefinitely.

Previous research on this issue, according to the Johns Hopkins team, has been based on analysis of racial differences in dialysis outcomes for all patients with end-stage kidney disease, a majority of whom are over the age of 50.

The new analysis continues to show a survival benefit for black patients over 50, though not a large one. But when the investigators looked at racial differences stratified by age, they found that the population-based analyses were camouflaging the fact that younger black patients do much worse on dialysis than white patients with a similar health status.

Specifically, results of the new study of 1.3 million patients with end-stage kidney disease show that black patients between the ages of 18 and 30 are twice as likely to die on dialysis than their white counterparts, and those ages 31 to 40 are 1.5 times as likely to die.

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Segev, a transplant surgeon, says that the results raise new questions about why this racial disparity in outcomes occurs at all. It is possible, he suggests, that the differences could be attributed to the lower socioeconomic status of many young African-Americans, who are less likely to have good insurance and may receive inadequate or no health care at the earlier stages of their disease. There is also the possibility that there are biological reasons for the disparity, perhaps involving hypertension, which is more prevalent and often more aggressive among African-Americans.

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  • Michigan Patriot

    Since these kidney machines were the creation of White people’s electronic and motorized mindset and most likely assembled by Whites originally, now diverse with talented Asians also; this dialysis machines are inheritantly bigoted against black patients. That is the only accepted and plausible responce from our communist, anti-White Christian media; so goes the prevailing propaganda.

  • olewhitelady

    I would bet that Dr. Segev nodded a “maybe” to a reporter’s question posing that blacks might get less adequete health care. What physician would agree to this premise? Moreover, the government takes over and pays for dialysis and related care because the costs are prohibitive for all but the filthy rich.

    I find it hard to believe that any properly done study ever showed that blacks do better on dialysis. They do have greater instances of hypertension and diabetes, and even those on Medicaid, Medicare, and good health insurance often don’t see that it’s treated. They also indulge in more kidney-damaging smoking, drinking, and crack use than most whites. They suffer from higher instances of diseases that damage the immune system, and they’re more noncompliant in keeping to diets necessary for kidney-failure patients.

  • Vic

    I hope this isn’t taken the wrong way but aren’t blacks less successful at everything?

    Sounds to me like it’s in the genes?

  • mobtown

    Jury is out today for the murder trial of the young Johns Hopkins medical researcher, 23 stabbed even after giving his book bag to a black man and his black wife in Baltimore while his mom listened to him being murdered on the phone just so these two people could supposedly buy crack. His name was Pitcairn if you want to read the story . Another ISOLATED incident in Mobtown. How many lives could this brilliant young researcher saved?

  • AnalogMan

    Since the courts have ruled that any disparate impact is prima facie evidence of racism, those machines are legally racist. And of course, as the article says, the remedy is more affirmative action kidney transplants. More White people will die to save their lives.

    I’m sure that, as olewhitelady suggests, the higher mortality among young blacks is probably due to lifestyle factors.

  • BILL R

    Blacks do worse in dialysis than Whites?

    Who cares?

    If so, it’s probably due to choosing poor diets, poor lifestyles (drugs, STD’s, alcohol, Purple Drang, etc) and being unable to think past today, thereby unable to get to dialysis on time, or before they are in crisis.

    But, really, who cares?

  • Anonymous

    Young blacks do not live a healthful lifestyle, so those with already compromised health will inevitably do worse in treatment.

  • Ted

    My 20 year experience in healthcare has proven that this is often because of their own personally responsibility (or lack of). They very frequently miss their appointments, don’t take their meds, and show up in an ER. This occurs frequently even when we make arrangements to pick them up, pay for meds and even have meds brought to them.

  • krn

    My mother was on dialysis for 15 years. She was very disciplined about what she ate and her fluid intake. She knew she needed to work closely with the kidney machine to prolong her life.

  • Bon, From the Land of Babble

    But new Johns Hopkins research, published Aug. 10 in the Journal of the American Medical Association, shows that younger blacks—those under the age of 50—actually do much worse on dialysis than equally sick whites who undergo the same blood-filtering process.

    Yeah, now blacks will demand affirmative action for their “fair share” of WHITE kidneys for transplant. Their own people do not donate because they’re afraid their kidneys will go to Whites!!

    Finding African-American organ donors is a critical problem. Nationwide, blacks make up more than 30 percent of all organ donor recipients but only 20 percent of all donors (15 percent in New Jersey).

    They have one of the highest needs for transplants but one of the lowest percentage of donors,” said Joseph Roth, president and CEO of the Sharing Network, an organ and tissues service that matches donors to patients. Blacks are nearly twice as likely as whites to suffer from diabetes and hypertension, which can lead to the need for an organ transplant if not properly treated. Blacks make up 40 percent of all cases of renal failure in the United States.

    Become angry about this too:

    The Houston Chronicle Online reports…124 undocumented immigrants donated organs, while 258 received them…

    NOW, take your name and that of your loved ones off of transplant lists unless YOU have control over WHO your organs or those of your loved ones goes to!! Check NO if your state has automatic organ donation permission included on your driver’s license. I and everyone in my family have done this.

    Although, at some point, I fully expect the government to over-ride YOUR wishes about organ donation and begin distributing scarce organs as “they” (non-White administrators) see fit –meaning AA for YOUR organs, YOUR organs handed over to blacks and mexicans.

    AA also means that that neither YOU nor your loved ones will receive organ transplants, even illegal aliens will be ahead of you in line!!

    Bon

  • Anonymous

    No mention of diet, exercise or life style choices (drugs and booze), just this nonsense!

    “he suggests, that the differences could be attributed to the lower socioeconomic status of many young African-Americans, who are less likely to have good insurance and may receive inadequate or no health care at the earlier stages of their disease.”

    Working hard in school so you have a good career that INCLUDES healthcare is completely out of the question.