ArticleClinical journal of the American Society of Nephrology : CJASN2008
Assessment of racial disparities in chronic kidney disease stage 3 and 4 care in the department of defense health system.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Determining the effects and challenges of incorporating genetic testing into primary care management of hypertensive patients with African ancestry.Contemporary clinical trials · 2016Trial
- Factors Associated With Non-vaccination for Influenza Among Patients With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Observational
- Use of New Audio-Only Telemedicine Claim Modifiers.JAMA network open · 2023Article
- Review
- Design and rationale of GUARDD-US: A pragmatic, randomized trial of genetic testing for APOL1 and pharmacogenomic predictors of antihypertensive efficacy in patients with hypertension.Contemporary clinical trials · 2022Article
- Trends in Chronic Kidney Disease Care in the US by Race and Ethnicity, 2012-2019.JAMA network open · 2021Article
- A computer-aided diagnostic system for kidney disease.Kidney research and clinical practice · 2017Article
- Race, Genomics and Chronic Disease: What Patients with African Ancestry Have to Say.Journal of health care for the poor and underserved · 2017Article
- Current State and Future Trends to Optimize the Care of African Americans with End-Stage Renal Disease.American journal of nephrology · 2017Review
- Age, Race and Cardiovascular Outcomes in African American Veterans.Ethnicity & disease · 2016Article
- Racial disparities in chronic kidney diseases in the United States; a pressing public health challenge with social, behavioral and medical causes.Journal of nephropharmacology · 2016Article
- Association of Race With Mortality and Cardiovascular Events in a Large Cohort of US Veterans.Circulation · 2015Article
- Racial disparities in kidney disease outcomes.Seminars in nephrology · 2013Article
- Kidney disease progression and screening cost-effectiveness among African Americans.Journal of the American Society of Nephrology : JASN · 2012Article
- The MDRD equation underestimates the prevalence of CKD among blacks and overestimates the prevalence of CKD among whites compared to the CKD-EPI equation: a retrospective cohort study.BMC nephrology · 2012Article
- Association of decreased glomerular filtration rate with racial differences in survival after acute myocardial infarction.Clinical journal of the American Society of Nephrology : CJASN · 2011Article
- Race disparities in U.S. nephrology fellowship training.Clinical journal of the American Society of Nephrology : CJASN · 2011Article
- Chronic kidney disease management in an academic internal medicine clinic.Clinical and experimental nephrology · 2010Article
- Racial differences in mortality and ESRD.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2008Article
- Racial disparities in chronic kidney disease: tragedy, opportunity, or both?Clinical journal of the American Society of Nephrology : CJASN · 2008Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesRacial disparities in provision of healthcare are widespread in the United States but have not been specifically assessed in provision of chronic kidney disease (CKD) care. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective cohort study of the clinical database used in a Department of Defense (DOD) medical system. Beneficiaries studied were DOD-eligible beneficiaries with CKD stage 3 (n = 7729) and 4 (n = 589) using the modified Modification of Diet in Renal Disease (MDRD)-estimated GFR formula but requiring manual correction for Black race. Compliance with selected Kidney Disease Outcomes Quality Initiative (KDOQI) CKD recommended targets (monitoring of recommended laboratory data, prescription of recommended medications, and referral to nephrology) was assessed over a 12-mo period, stratified by CKD stage. Logistic regression analysis was used to assess whether race (White, Black, or other) was independently associated with provider compliance with targets, adjusted for demographic factors and burden of comorbid conditions.
resultsAmong the targets, only monitoring of LDL cholesterol was significantly less common among Blacks. For all other measures, compliance was either not significantly different or significantly higher for Black compared with White beneficiaries. However, patients categorized as "Other" race were in general less likely to achieve targets than Whites, and at stage 3 CKD significantly less likely to achieve targets for monitoring of phosphorous, hemoglobin, and vitamin D.
conclusionsIn the DOD health system, provider compliance with selected CKD stage 3 and 4 targets was not significantly lower for Black beneficiaries than for Whites, with the exception of LDL cholesterol monitoring. Patients classified as Other race were generally less likely to achieve targets than Whites, in some patients significantly so.
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