Observational studyJournal of the American Society of Nephrology : JASN2018
Racial Disparities in Nephrology Consultation and Disease Progression among Veterans with CKD: An Observational Cohort Study.
Observational study in Journal of the American Society of Nephrology : JASN, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 30 citations in OpenAlex.
- Mortality trends involving chronic kidney disease and electrolyte and acid-base disorders in the United States, 1999-2023: a CDC WONDER analysis.Annals of medicine and surgery (2012) · 2026Article
- Microfluidic innovations in chronic kidney disease and renal fibrosis: from mechanistic insights to clinical applications.Frontiers in medicine · 2026Review
- Renin-Angiotensin System Inhibitors in Patients With Nonproteinuric Chronic Kidney Disease and Kidney Outcomes: Findings From the CRIC Study.Kidney medicine · 2026Article
- Race- and Ethnicity-Related Disparities in Predialysis Nephrology Care, Kidney Disease Education, and Home Dialysis Utilization.Journal of the American Society of Nephrology : JASN · 2025Article
- Enhancing Clinical Decision Support in Nephrology: Addressing Algorithmic Bias Through Artificial Intelligence Governance.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Review
- Chronic Kidney Disease Progression-A Challenge.Biomedicines · 2024Review
- Utility of the Kidney Failure Risk Equation and Estimated GFR for Estimating Time to Kidney Failure in Advanced CKD.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Article
- Review
- The Role of miRNA in Renal Fibrosis Leading to Chronic Kidney Disease.Biomedicines · 2023Review
- Folic acid-mediated fibrosis is driven by C5a receptor 1-mediated activation of kidney myeloid cells.American journal of physiology. Renal physiology · 2022Article
- CKD Progression From the Time of Estimated GFR-Based Waitlist Eligibility and Racial Disparities in Transplant Access.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Racial and Socioeconomic Disparities in CKD in the Context of Universal Health Care Provided by the Military Health System.Kidney medicine · 2022Article
- Structural Inequities and Barriers to Accessing Kidney Healthcare Services in the United States: A Focus on Uninsured and Undocumented Children and Young Adults.Frontiers in pediatrics · 2022Article
- Trends in Chronic Kidney Disease Care in the US by Race and Ethnicity, 2012-2019.JAMA network open · 2021Article
- A Step Toward Health Equity for Veterans: Evidence Supports Removing Race From Kidney Function Calculations.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2021Article
- Testing for Primary Aldosteronism and Mineralocorticoid Receptor Antagonist Use Among U.S. Veterans : A Retrospective Cohort Study.Annals of internal medicine · 2021Article
- Can Understanding Outcomes for Medicare Advantage Enrollees Reduce Racial and Ethnic Disparities in Kidney Disease?American journal of nephrology · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIncident rates of ESRD are much higher among black and Hispanic patients than white patients. Access to nephrology care before progression to ESRD is associated with better clinical outcomes among patients with CKD. However, it is unknown whether black or Hispanic patients with CKD experience lower pre-ESRD nephrology consultation rates compared with their white counterparts, or whether such a disparity contributes to worse outcomes among minorities.
methodsWe assembled a retrospective cohort of patients with CKD who received care through the Veterans Health Administration from 2003 to 2015, focusing on individuals with incident CKD stage 4 who had an initial eGFR≥60 ml/min per 1.73 m
resultsWe identified 56,767 veterans with CKD stage 4 and 640,704 with CKD stage 3. In both cohorts, rates of nephrology referral and visits were significantly higher among black and Hispanic veterans than among non-Hispanic white veterans. Despite this, both black and Hispanic patients experienced faster progression to CKD stage 5 compared with white patients. Black patients with CKD stage 4 experienced slightly lower mortality than white patients, whereas black patients with CKD stage 3 had a small increased risk of death.
conclusionsBlack or Hispanic veterans with CKD are more likely than white patients to see a nephrologist, yet are also more likely to suffer disease progression. Biologic and environmental factors may play a bigger role than nephrology consultation in driving racial disparities in CKD progression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.