期刊
AMERICAN JOURNAL OF NEPHROLOGY
卷 33, 期 2, 页码 157-167出版社
KARGER
DOI: 10.1159/000323972
关键词
Black race; Hispanic ethnicity; African Americans; Non-Hispanic White; Nutritional status; Inflammatory markers; Dietary intake; Survival
资金
- DaVita Wild West and Gold Coast dietitians
- National Institutes of Health [DK61162, DK078012, RR026138, MD00182, MD000103]
- DaVita Clinical Research
- Mr. Harold Simmons and a General Clinical Research Center [M01-RR00425]
- National Centers for Research Resources, National Institutes of Health
- National Research Fund [NKTH-OTKA-EU 7KP-HUMAN-MB08-A-81231]
- Hungarian Academy of Sciences
- Hungarian Eotvos Scholarship [MOB/66-2/2010]
- NATIONAL CENTER FOR RESEARCH RESOURCES [U54RR026138, M01RR000425] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R21DK078012, R01DK078106, K23DK061162] Funding Source: NIH RePORTER
- National Institute on Minority Health and Health Disparities [S21MD000103, P20MD000182] Funding Source: NIH RePORTER
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-alpha, were associated with increased mortality. The highest (vs. lowest) quartile of IL-6 was associated with a 2.4-fold (95% Cl: 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. Copyright (C) 2011 S. Karger AG, Basel
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