Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease : a systematic scoping review

Hounkpatin, HO; Fraser, SDS; Honney, R; Dreyer, G; Brettle, AJ; Roderick, PJ

Abstract

Background: There are a growing number of studies on ethnic differences in progression and mortality for pre-dialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality. Methods: This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020. Results: 8059 articles were identified and screened. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups. Conclusions: Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.

Citation

Hounkpatin, H., Fraser, S., Honney, R., Dreyer, G., Brettle, A., & Roderick, P. (2020). Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease : a systematic scoping review. BMC Nephrology, 21(1), 217. https://doi.org/10.1186/s12882-020-01852-3

• Journal Article Type: Article
• Acceptance Date: May 12, 2020
• Online Publication Date: Jun 9, 2020
• Publication Date: Jun 9, 2020
• Deposit Date: Jun 11, 2020
• Publicly Available Date: Jun 11, 2020
• Journal: BMC Nephrology
• Publisher: Springer Verlag
• Volume: 21
• Issue: 1
• Pages: 217
• DOI: https://doi.org/10.1186/s12882-020-01852-3
• Keywords: Research Article, Epidemiology and Health Outcomes, Chronic kidney disease, Epidemiology, End stage renal disease, Ethnicity, Pre-dialysis
• Publisher URL: https://doi.org/10.1186/s12882-020-01852-3
• Related Public URLs: http://www.biomedcentral.com/bmcnephrol/
• Additional Information: Additional Information : ** From Springer Nature via Jisc Publications Router ** Licence for this article: https://creativecommons.org/licenses/by/4.0/ **Journal IDs: eissn 1471-2369 **Article IDs: publisher-id: s12882-020-01852-3; manuscript: 1852 **History: collection 12-2020; published_online 09-06-2020; online 09-06-2020; registration 13-05-2020; accepted 12-05-2020; submitted 14-11-2018