Evidence map›Paper›PMID 40691762›Full record

ArticleBMC nephrology2025

Clinical characteristics and CKD care delivery in African American and American Indian or Alaska Native patients: A real-world cohort study.

Kiara N Mayhand, Radica Z Alicic, Lindsey M Kornowske, Cami R Jones, Kenn B Daratha, Christina L Reynolds, Susanne B Nicholas, Roland J Thorpe, Alex A T Bui, Keith C Norris and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kiara N MayhandDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. kmayhan1@jhu.edu.
Radica Z AlicicProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.
Lindsey M KornowskeProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.
Cami R JonesProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.
Kenn B DarathaProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.
Christina L ReynoldsProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.
Susanne B NicholasDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Roland J ThorpeDepartment of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Alex A T BuiDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Keith C NorrisDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Katherine R TuttleProvidence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.

Funding

Prediction of Chronic Kidney Disease by Simulation Modeling to Improve the Health of Minority PopulationsR01MD014712 · NIMHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI BUI, ALEX, NICHOLAS, SUSANNE B · 2020 to 2023
$1.5M
National Institutes of Health (NIH) 1OT2OD032581-01NIMHD NIH HHS R01 MD014712
6 · The paper itself

Abstract

backgroundRacially minoritized populations in the United States (US), notably African American (AA) and American Indian/Alaska Native (AI/AN), experience disproportionately higher rates of chronic kidney disease (CKD), diabetes, and hypertension compared to their White peers but are understudied. This real-world cohort study examines the standards of CKD care provided to these groups in two US health systems.

methodsUsing electronic health record data from the Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry (N = 381,011) collected between 2015 and 2020, adjusted binary logistic regression models were used to identify predictors of two CKD care outcomes: 1) prescriptions for CKD-related guideline-directed medical therapy (CKD-GDMT) in the form of angiotensin converting enzyme inhibitors or angiotensin receptor blockers and 2) testing for urine albumin-creatinine/urine protein-creatinine ratio (UACR/UPCR) among adult patients of AA and AI/AN race compared to the reference group (White, non-Hispanic).

resultsAA (62 ± 17 years) and AI/AN (57 ± 18 years) patients with CKD were younger compared to the White, non-Hispanic reference group (68 ± 17 years). Diabetes and hypertension were the most important predictors for increased odds of CKD-GDMT and UACR/UPCR testing. Prevalence of CKD-GDMT was only 46%, 40% and 38% in AA, White, and AI/AN patients, respectively. AA patients were more likely to receive CKD-GDMT prescriptions (OR = 1.20, 95% CI: 1.17-1.23, p < 0.001) and UACR/UPCR testing (OR = 1.34, 95% CI: 1.29-1.38, p < 0.001) compared to White patients. AI/AN were also more likely to receive GDMT (OR = 1.07, 95% CI: 1.00-1.15, p = 0.046) compared to White patients but had lower odds of UACR/UPCR testing (OR = 0.73, 95% CI: 0.67-0.81, p < 0.001). However, the frequency or prescribing of CKD-GDMT and UACR/UPCR testing were suboptimal across all examined racial identity groups. Exploratory machine learning approaches, including logistic regression, lasso regression, and random forest found similar findings.

conclusionsWhile there were modest racial differences in the prescription of CKD-GDMT and frequency of UACR/UPCR testing, rates were lower than expected in this high-risk population. Our findings suggest the disproportionate burden of CKD on AA and AI/AN individuals is not solely attributable to the current standards of care delivery. The relatively higher rates of CKD-GDMT for AA patients may be due to clinician recognition of their increased risk for progressing to kidney failure. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Black or African AmericanDelivery of Health CareRenal Insufficiency, ChronicAdultAgedAmerican Indian or Alaska NativeAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCohort StudiesFemaleHumansHypertensionMaleMiddle AgedRegistriesUnited StatesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAlbuminuriaAngiotensin converting enzyme inhibitorsAngiotensin receptor blockersGuideline-directed medical therapiesMachine learningRacial health disparities

Identifiers

PMID40691762
PMCPMC12278548

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.