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

Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review
Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review
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
8,059 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.
Chronic kidney disease, End stage renal disease, Epidemiology, Ethnicity, Pre-dialysis
1471-2369
Hounkpatin, Hilda
5612e5b4-6286-48c8-b81f-e96d1148681d
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Honney, Rory
af8e2219-9ed1-474b-9db8-a066fa0ae07e
Dreyer, Gavin
db644a0f-1217-42a4-a4fe-4d7203d23592
Brettle, Alison
505629a8-e4bb-4a0e-b2fa-647c89face8e
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Hounkpatin, Hilda
5612e5b4-6286-48c8-b81f-e96d1148681d
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Honney, Rory
af8e2219-9ed1-474b-9db8-a066fa0ae07e
Dreyer, Gavin
db644a0f-1217-42a4-a4fe-4d7203d23592
Brettle, Alison
505629a8-e4bb-4a0e-b2fa-647c89face8e
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a

Hounkpatin, Hilda, Fraser, Simon, Honney, Rory, Dreyer, Gavin, Brettle, Alison and Roderick, Paul (2020) Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review. BMC Nephrology, 21 (1), [217]. (doi:10.1186/s12882-020-01852-3).

Record type: Article

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
8,059 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.

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More information

Accepted/In Press date: 12 May 2020
e-pub ahead of print date: 9 June 2020
Published date: 2020
Keywords: Chronic kidney disease, End stage renal disease, Epidemiology, Ethnicity, Pre-dialysis

Identifiers

Local EPrints ID: 440681
URI: http://eprints.soton.ac.uk/id/eprint/440681
ISSN: 1471-2369
PURE UUID: 2489cf00-8098-4432-9e0c-4b1a36508159
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 13 May 2020 16:34
Last modified: 22 Nov 2021 02:56

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Contributors

Author: Simon Fraser ORCID iD
Author: Rory Honney
Author: Gavin Dreyer
Author: Alison Brettle
Author: Paul Roderick ORCID iD

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