The Reply

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We thank Pazmiño for his interest in our article1Choi A.I. Rodriguez R.A. Bacchetti P. et al.White/black racial differences in risk of end-stage renal disease and death.Am J Med. 2009; 122: 672-678Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar and for his important comments on the burden of kidney disease among Hispanics in this country. In our study, we focused on the disparities in risk of mortality and end-stage renal disease between white and black patients. Non-black race/ethnic minorities represent approximately 6% of the patients receiving care in the Veterans Health Administration, therefore, we were underpowered to examine end-stage renal disease and mortality in these groups.2Sohn M.W. Zhang H. Arnold N. et al.Transition to the new race/ethnicity data collection standards in the Department of Veterans Affairs.Popul Health Metr. 2006; 4: 7Crossref PubMed Scopus (80) Google Scholar However, we are in complete agreement with Pazmiño that disparities in kidney disease are not limited to blacks and that public health efforts to reduce the burden of kidney disease will need to account for Hispanics—who are a rapidly increasing segment of the population—along with other underrepresented groups. We plan further study of kidney disease in these race/ethnic minority groups in the future. We thank Pazmiño for his interest in our article1Choi A.I. Rodriguez R.A. Bacchetti P. et al.White/black racial differences in risk of end-stage renal disease and death.Am J Med. 2009; 122: 672-678Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar and for his important comments on the burden of kidney disease among Hispanics in this country. In our study, we focused on the disparities in risk of mortality and end-stage renal disease between white and black patients. Non-black race/ethnic minorities represent approximately 6% of the patients receiving care in the Veterans Health Administration, therefore, we were underpowered to examine end-stage renal disease and mortality in these groups.2Sohn M.W. Zhang H. Arnold N. et al.Transition to the new race/ethnicity data collection standards in the Department of Veterans Affairs.Popul Health Metr. 2006; 4: 7Crossref PubMed Scopus (80) Google Scholar However, we are in complete agreement with Pazmiño that disparities in kidney disease are not limited to blacks and that public health efforts to reduce the burden of kidney disease will need to account for Hispanics—who are a rapidly increasing segment of the population—along with other underrepresented groups. We plan further study of kidney disease in these race/ethnic minority groups in the future. Influence of Hispanic Ethnicity and Diabetic End-stage Renal DiseaseThe American Journal of MedicineVol. 123Issue 3PreviewI read with interest the large national Veterans Administration cohort study by Choi et al1 on the white/black racial differences in risk of end-stage renal disease and death. In the results section, it is noted that 325,568 or 13.9% of patients with nonwhite/black or unknown race were excluded. This study of patients receiving care in the Veterans Health Administration is then based on analysis of 2,015,891 (84.5%) patients (1,704,101 white and 311,790 black patients), and it would be important to find out if they have data analysis of the Veterans Administration groups studied according to ethnicity (Hispanic, non-Hispanic, or unknown). Full-Text PDF