| Racial and ethnic differences in mortality of hemodialysis patients: role of dietary and nutritional status and inflammation. | |
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MedLine Citation:
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PMID: 21293117 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Racial/ethnic disparities prevail among hemodialysis patients. We hypothesized that significant differences exist between Black and non-Hispanic and Hispanic White hemodialysis patients in nutritional status, dietary intake and inflammation, and that they account for racial survival disparities. METHODS: In a 6-year (2001-2007) cohort of 799 hemodialysis patients, we compared diet and surrogates of nutritional-inflammatory status and their mortality-predictabilities between 279 Blacks and 520 Whites using matched and regression analyses and Cox with cubic splines. RESULTS: In age-, gender- and diabetes-matched analyses, Blacks had higher lean body mass and serum prealbumin, creatinine and homocysteine levels than Whites. In case-mix-adjusted analyses, dietary intakes in Blacks versus Whites were higher in energy (+293 ± 119 cal/day) and fat (+18 ± 5 g/day), but lower in fiber (-2.9 ± 1.3 g/day) than Whites. In both races, higher serum albumin, prealbumin and creatinine were associated with greater survival, whereas CRP and IL-6, but not TNF-α, were associated with increased mortality. The highest (vs. lowest) quartile of IL-6 was associated with a 2.4-fold (95% CI: 1.3-3.8) and 4.1-fold (2.2-7.2) higher death risk in Blacks and Whites, respectively. CONCLUSIONS: Significant racial disparities exist in dietary, nutritional and inflammatory measures, which may contribute to hemodialysis outcome disparities. Testing race-specific dietary and/or anti-inflammatory interventions is indicated. |
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Authors:
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Nazanin Noori; Csaba P Kovesdy; Ramanath Dukkipati; Usama Feroze; Miklos Z Molnar; Rachelle Bross; Allen R Nissenson; Joel D Kopple; Keith C Norris; Kamyar Kalantar-Zadeh |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-02-04 |
Journal Detail:
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Title: American journal of nephrology Volume: 33 ISSN: 1421-9670 ISO Abbreviation: Am. J. Nephrol. Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-04 Completed Date: 2011-06-21 Revised Date: 2012-03-01 |
Medline Journal Info:
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Nlm Unique ID: 8109361 Medline TA: Am J Nephrol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 157-67 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Harold Simmons Center for Chronic Disease Research and Epidemiology, Torrance, Calif., USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Anti-Inflammatory Agents / pharmacology Body Composition C-Reactive Protein / biosynthesis Ethnic Groups Female Humans Inflammation* Interleukin-6 / blood Kidney Failure, Chronic / epidemiology*, ethnology* Male Nutritional Status* Proportional Hazards Models Renal Dialysis / methods* Sex Factors Tumor Necrosis Factor-alpha / blood |
| Grant Support | |
ID/Acronym/Agency:
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DK078012/DK/NIDDK NIH HHS; DK61162/DK/NIDDK NIH HHS; K23 DK061162-05/DK/NIDDK NIH HHS; M01-RR00425/RR/NCRR NIH HHS; MD000103/MD/NIMHD NIH HHS; MD00182/MD/NIMHD NIH HHS; R01 DK078106-04/DK/NIDDK NIH HHS; RR026138/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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