Increased Risk of Death in Young African American Dialysis PatientsYoung African American Dialysis Patients

Relative to other ethnic groups, African Americans are disproportionately affected by the major diseases that cause end-stage renal disease.^1- 2 Increased risk, inadequate medical insurance, and limited access to care result in an excess of African Americans among the end-stage renal disease population.^3- 5 One would expect that African Americans undergoing dialysis might subsequently experience decreased survival. In contrast, numerous studies^6- 8 have shown that African Americans undergoing dialysis have lower mortality rates than whites undergoing dialysis. An unintended consequence of this finding is that African Americans are less likely to be referred for a kidney transplant because of the mistaken belief that they will realize little benefit.⁹ In this JAMA article by Kucirka and colleagues, a novel, age-stratified analysis is presented that helps to debunk the conventional wisdom that all African Americans experience a lower dialysis-associated risk of mortality than whites.