Abstract
ObjectiveThe Roma minority represents the largest ethnic group in Central and South-East European countries. Data regarding the mortality in Roma hemodialysis subjects are limited. We evaluated the 3 year mortality of ESRD Roma patients treated with hemodialysis (HD).Study Design and SettingOur prospective cohort study included 600 ESRD patients on HD therapy recruited from 7 HD centers, from the main geographical regions of Romania. The median age of the patients was 56 (19) years, 332 (55.3%) being males, 51 (8.5%) having Roma ethnicity.ResultsRoma ESRD patients initiate dialysis at a younger age, 47.8 years vs. 52.3 years (P = 0.017), present higher serum albumin (P = 0.013) and higher serum phosphate levels (P = 0.021). In the Roma group, the overall 3 year mortality was higher when compared to Caucasians (33.3% vs. 24.8%). The multivariate survival analysis revealed that being of Roma ethnicity is an independent risk factor for mortality (HR = 1.74; 95% CI = 1.04–2.91; P = 0.035).ConclusionsRoma patients with ESRD initiate HD therapy at a younger age as compared to Caucasians. They have a higher 3 year mortality rate and are dying at a younger age. Roma ethnicity represents an independent risk factor for mortality in our cohort.
Highlights
Recent epidemiology data have shown that the Roma minority represents the largest ethnic group in Central and South-East European countries [1].Several studies showed a higher prevalence of chronic diseases in the Roma minority in comparison to the general population [2, 3, 4]
The multivariate survival analysis revealed that being of Roma ethnicity is an independent risk factor for mortality (HR = 1.74; 95% CI = 1.04–2.91; P = 0.035)
These findings, along with genetic, social, cultural and economic contributors, may explain the 20% prevalence of chronic kidney disease (CKD) in this ethnic group [4], with a relative risk of progressing to end stage renal disease (ESRD) 1.34 times higher comparing to the general population [5]
Summary
Several studies showed a higher prevalence of chronic diseases (hypertension, diabetes, chronic respiratory disease, obesity, metabolic syndrome) in the Roma minority in comparison to the general population [2, 3, 4]. These findings, along with genetic, social, cultural and economic contributors, may explain the 20% prevalence of chronic kidney disease (CKD) in this ethnic group [4], with a relative risk of progressing to end stage renal disease (ESRD) 1.34 times higher comparing to the general population [5].
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