Black Veterans With Chronic Kidney Disease Experience Earlier Onset, Higher Risk of Kidney Failure

Guofen Yan, PhD

Investigators assessed US veterans with chronic kidney disease (CKD) to determine the population's risk of kidney failure and death. While the overall risk of death was comparable in Black and White individuals, Black individuals displayed a higher risk for going into kidney failure earlier than White individuals.

These findings indicated the vulnerability of Black individuals in the early years following kidney disease onset.

The study conducted by Guofen Yan, PhD, University of Virginia, and a team of investigators included 180,881 White veterans and 32,187 Black veterans who were diagnosed with CKD from 2003-2008, and observed disease progression through 2018.

"Despite an overall similar mortality risk after adjusting for major confounding factors, there was a greater risk of death for Blacks during the first 4 years of CKD onset, followed by a lower risk thereafter," investigators wrote.

The adjusted risk of kidney failure was 30% greater in Black individuals when compared with White individuals in this study population. However, investigators noted that the difference was prominent in the subsequent years of CKD onset.

Rates of kidney failure risk in Black individuals were 38% higher in the first 2 years of developing the disease. When looking at 8-10 years following disease onset in these individuals, the risk for failure compared with White individuals dropped to an increased risk of 8%.

The risk differences of each racial group showed to be consistent over time and across subgroups like those with and without hypertension, diabetes, cardiovascular diseases, and other comorbidities.

“Black adults are particularly susceptible to kidney failure and death during the first several years of CKD onset," Yan said in a statement. "This result demands a stronger urgency for close evaluation in the earlier years of CKD to improve outcomes.”

The study, "Time-dependent risk differences in kidney failure and death between Black and White veterans following incident CKD" was presented today at the 2022 American Society of Nephrology (ASN) Annual Meeting.