End-stage renal disease in Indo-Asians in the North-West of England
| Autor: | A. Trehan, M. Venning, A.M. MacLeod, R. Coward, R. Gokal, B. Lane, J. Winterbottom, Robert N. Foley |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population urologic and male genital diseases End stage renal disease Nephropathy Cohort Studies Age Distribution Internal medicine medicine Asia Western Humans Renal replacement therapy Prospective Studies education Prospective cohort study Dialysis education.field_of_study business.industry Incidence (epidemiology) Incidence General Medicine Middle Aged Patient Acceptance of Health Care medicine.disease Surgery Renal Replacement Therapy England Multivariate Analysis Kidney Failure Chronic Regression Analysis Female business Cohort study |
| Zdroj: | QJM : monthly journal of the Association of Physicians. 96(7) |
| ISSN: | 1460-2725 |
| Popis: | Summary Background: The incidence of end-stage renal disease (ESRD) in England is increasing. There is a higher incidence of ESRD in British Indo-Asians than in the White population. Aim: To determine to what degree the increasing demand for renal replacement therapy in the UK is due to Indo-Asian patients. To study the presentation to renal services of Indo-Asian patients with ESRD and report any inequalities in initial treatment of Indo-Asian patients with ESRD compared to their White counterparts. Design: Prospective, inception cohort study. Methods: Consecutive adult patients with ESRD who started renal replacement therapy between 1 April 2000 and 31 December 2001 in all 14 renal units serving an area from North Cheshire to South Cumbria, including Greater Manchester and Lancashire, were recruited and interviewed. Results: Of the 578 patients, 9.5% were Indo-Asian. The annual acceptance rate for renal replacement therapy was 342 per million population in Indo-Asians, compared with 91 per million population in the White population ( p < 0.001). Indo-Asian patients with ESRD were younger (median age 51 years vs. 60 yrs, p ¼ 0.006) and more socially deprived (81% vs. 36.5% in the 5th Carstairs quintile, p < 0.001). A greater proportion of IndoAsian patients with ESRD presented late to specialist renal services (31% vs. 19%, p ¼ 0.03). Once adjusting for their younger age, atherosclerotic renovascular disease and/or hypertensive nephropathy was more prevalent in Indo-Asian patients (OR 4.9; p ¼ 0.03). There was no difference in the initial mode of maintenance dialysis or the perception of choice the patients felt they had, based on their ethnicity. Discussion: There is a silent epidemic of ESRD in Indo-Asian patients in the North-West, possibly vascular in aetiology, in which specialist intervention is late. This suggests that Indo-Asian patients should be prioritized for early intervention strategies to reduce the burden of ESRD. |
| Databáze: | OpenAIRE |
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