Inequalities and outcomes : end stage kidney disease in ethnic minorities

Wilkinson, E, Brettle, AJ ORCID:, Waqar, M and Randhawa, G ORCID: 2019, 'Inequalities and outcomes : end stage kidney disease in ethnic minorities' , BMC Nephrology, 20 (1) , p. 234.

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The international evidence about outcomes of End Stage Kidney Disease (ESKD) for ethnic minorities was reviewed to identify gaps and make recommendations for researchers and policy makers. Nine databases were searched systematically with 112 studies from 14 different countries included and analysed to produce a thematic map of the literature. Reviews (n = 26) highlighted different mortality rates and specific causes between ethnic groups and by stage of kidney disease associated with individual, genetic, social and environmental factors. Primary studies focussing on uptake of treatment modalities (n = 19) found ethnic differences in access. Research evaluating intermediate outcomes and quality of care in different treatment phases (n = 35) e.g. dialysis adequacy, transplant evaluation and immunosuppression showed ethnic minorities were disadvantaged. This is despite a survival paradox for some ethnic minorities on dialysis seen in studies of longer term outcomes (n = 29) e.g. in survival time post-transplant and mortality. There were few studies which focussed on end of life care (n = 3) and ethnicity. Gaps identified were: limited evidence from all stages of the ESKD pathway, particularly end of life care; a lack of system oriented studies with a reliance on national routine datasets which are limited in scope; a dearth of qualitative studies; and a lack studies from many countries with limited cross country comparison and learning. Differences between ethnic groups occur at various points and in a variety of outcomes throughout the kidney care system. The combination of individual factors and system related variables affect ethnic groups differently indicating a need for culturally intelligent policy informed by research to prevent disadvantage.

Item Type: Article
Additional Information: ** From PubMed via Jisc Publications Router **Journal IDs: eissn 1471-2369 **Article IDs: pubmed: 31242862; pii: 10.1186/s12882-019-1410-2 **History: accepted 06-06-2019; submitted 14-11-2018
Schools: Schools > School of Health and Society
Journal or Publication Title: BMC Nephrology
Publisher: BioMed Central
ISSN: 1471-2369
Related URLs:
Funders: Kidney Research UK
SWORD Depositor: Publications Router
Depositing User: Publications Router
Date Deposited: 06 Dec 2019 14:10
Last Modified: 16 Feb 2022 02:19

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