ArticleJournal of racial and ethnic health disparities2025
Evaluating Disparities in End-Stage Kidney Disease Survival Among American Indian/Alaska Native Persons with Diabetes.
Article in Journal of racial and ethnic health disparities, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The prediction of all-cause mortality in end-stage kidney disease patients using social determinants of health: A machine learning framework.Informatics in medicine unlocked · 2026Article
- The Association of Social Determinants of Health on Mortality among Adults with End-Stage Kidney Disease: a Systematic Review and Meta-Analysis.Journal of racial and ethnic health disparities · 2026Review
- Hospice Referral Rate Disparities of American Indian/Alaska Native Kidney Transplant Recipients with End-Stage Kidney Disease: A Retrospective Cohort Analysis.The American journal of hospice & palliative care · 2026Article
- Predicting Hospice Use Among American Indian/Alaska Native Persons with End-Stage Kidney Disease.medRxiv : the preprint server for health sciences · 2026Article
- Global landscape of kidney health across Indigenous populations.Nature reviews. Nephrology · 2026Review
- Development and Validation of Survival Scores and the Assessment of Spatial Trends in End-Stage Kidney Disease Outcomes.Research square · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundAmerican Indian/Alaska Natives (AI/ANs) disproportionately suffer from diabetes compared to non-Hispanic whites (NHW). In 2013, 69% of end-stage kidney disease (ESKD) in AI/ANs was caused by diabetes (ESKD-D) but accounts for only 44% of ESKD diagnoses in the overall USA population. Moreover, the diagnosis of diabetes and ESKD-D may be significantly related to social determinants of health. The purpose of this study was to conduct a survival analysis of AI/ANs and NHWs diagnosed with ESKD-D nationally and by Indian Health Service region and correlate the survival analysis to the Area Deprivation Index® (ADI®).
methodsThis manuscript reports a retrospective cohort analysis of 2021 United States Renal Data System data. Eligible patient records were AI/AN and NHWs with diabetes as the primary cause of ESKD and started dialysis on January 1, 2014, or later.
resultsA total of 81,862 patient records were included in this analysis, of which 1798 (2.2%) were AI/AN. AI/ANs survive longer, with an 18.4% decrease in risk of death compared to NHW. However, AI/ANs are diagnosed with ESKD-D and start dialysis earlier than NHWs. ADI® variables became significant as ADI® ratings increased, meaning persons with greater social disadvantage had worse survival outcomes.
conclusionsThe findings reveal that AI/ANs have better survival outcomes than NWH, explained in part by initiating dialysis earlier than NHW. Additional research is needed to explore factors (e.g., social determinants; cultural; physiologic) that contribute to earlier diagnosis of ESKD-D in AI/ANs and the impact of prolonged dialysis on quality of life of those with ESKD-D.
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