Skip to main content
Article thumbnail
Location of Repository

Ethnicity and Renal Replacement Therapy

By John Feehally


This is the author's final draft of the paper published as Blood Purification, 2010, 29 (2), pp. 125-129. The final version is available from Copyright © 2010 S. Karger AG, Basel. Doi: 10.1159/000245638There are significant ethnic variations in the incidence of kidney disease. White European populations appear to be uniquely protected compared to increased incidences of end-stage renal disease in indigenous and migrant ethnic minority populations. This increase is partly explained by a high prevalence of diabetic nephropathy, but there is also an increased susceptibility to a range of other renal diseases. The relative contributions of genetic, environmental and fetal environmental factors to this susceptibility are not yet well understood. Strategies for early detection and management of chronic kidney disease to delay progression are particularly critical in countries where access to renal replacement therapy (RRT) is restricted. In developed countries with wide availability of RRT, resources to provide dialysis will need to be increased in regions with substantial minority populations. There is apparently counterintuitive evidence that survival on dialysis is increased in many minority populations. Access to renal transplantation, both from deceased and living donors, is also restricted in many minority populations, and graft survival is often inferior. Analysis of the explanations for these differences is complex because of the many confounding factors (for example cultural, social and economic) which typically cosegregate with ethnicity. Nevertheless, reduction of the varied and substantial inequities faced by ethnic minority populations with kidney disease is an important responsibility for the renal community

Publisher: Karger
Year: 2010
DOI identifier: 10.1159/000245638
OAI identifier:

Suggested articles


  1. (2002). al: A decade of experience with renal transplantation in African Americans. Ann Surg 236:794-804,
  2. (1989). al: Renal insufficiency in treated essential hypertension. doi
  3. Anemia of chronic kidney disease and end-stage renal disease: are there unique issues in disadvantaged populations? Ethn Dis.
  4. (2008). Annual Data Report: Atlas of Chronic Kidney doi
  5. (2009). Casula A et al. Survival of patients from South Asian and Black populations starting renal replacement therapy in England and Wales. Nephrol Dial Transplant. doi
  6. Choy CBY et al: A retrospective survey of attitudes toward acceptance of peritoneal dialysis in Chinese end-stage renal failure patients in Hong Kong – from a cultural point of view. Perit Dial Int 3:S318-S321,
  7. (1997). Diabetes and renal failure in Indo-Asians in the UK - a paradigm for the study of disease susceptibility. doi
  8. (2001). Diabetic renal disease in transitional and disadvantaged populations. doi
  9. (2009). Differences in mortality among Mexican-American, Puerto Rican, and Cuban-American dialysis patients in the United States. Am J Kidney Dis. doi
  10. (2002). Do demographic variables affect the timing of referral to a nephrologist? doi
  11. (2003). Epidemic of diabetic and non-diabetic renal disease among the Zuni Indians: the Zuni Kidney Project. doi
  12. (2004). Exploring the pathways leading from disadvantage to end-stage renal disease for indigenous Australians. Soc Sci Med 58:767-785, doi
  13. (1995). High incidence of end-stage renal disease in Indo-Asians in the UK.
  14. (1998). Hypertension control and access to health care in the inner city. doi
  15. (1992). Increased incidence of endstage renal failure secondary to diabetes mellitus in Asian ethnic groups in the United Kingdom. Diab Med 9:641-645, doi
  16. (2003). Nephrology Forum: To have and have not: Health and health care disparities in chronic kidney disease. Kidney Int 64:763-772, doi
  17. (2004). Physicians’ beliefs about racial differences in referral for renal transplantation. Am J Kidney Dis 43:350-357, doi
  18. (2009). Racial/ethnic disparity in kidney transplantation outcomes: influence of donor and recipient characteristics. J Natl Med Assoc. doi
  19. (2000). Renal disease in Australian Aborigines. doi
  20. (2007). Renal transplantation in the United Kingdom for patients from ethnic minorities. Transplantation. doi
  21. (2003). Shlipak MG: Racial differences in the progression from chronic renal insufficiency to end-stage renal disease in the United States. doi
  22. (2003). Szeto CC: Is there a survival advantage in Asian peritoneal dialysis patients? doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.