April 1992

Race and Dialysis Survival

Author Affiliations

Philadelphia, Pa

Arch Intern Med. 1992;152(4):879. doi:10.1001/archinte.1992.00400160159034

To the Editor. —  The excellent editorial by Tierney et al1 concerning the hypertensive nephropathy of blacks contained a misconception that deserves comment. While it is stated that blacks have a poorer survival rate with dialysis than whites, most articles2-5 have determined the contrary.In analyzing the survival of greater than 4000 patients with end-stage renal disease from 1977 through 1981, Held et al2 reported that the relative risk of death for patients undergoing dialysis was 0.84 for blacks compared with that for whites.Data from the 1990 Annual Data Report of the United States Renal Data System,3 encompassing almost all American patients undergoing dialysis, showed that, among patients who had already survived 90 days of dialysis, the fraction of black patients surviving 2 and 5 years was greater than the fraction of nonblack patients. The rate of surviving to 5 years in the 1984 incident

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