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      Keloids and End-Stage Renal Disease

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          Race and end-stage renal disease. Socioeconomic status and access to health care as mediating factors.

          To examine whether lower socioeconomic status and limited access to health care explain the racial inequities in the incidence of end-stage renal disease (ESRD), and whether these factors are independently associated with ESRD. This case-control study compared 716 patients with ESRD with 361 population controls of the same age, 20 to 64 years old, from Maryland, Virginia, West Virginia, and Washington, DC. Race, indicators of socioeconomic status (household annual income, years of education), and indicators of access to health care (health insurance status, number of missing teeth, usual source of care, use of preventive services) were assessed via a telephone interview. Independent risk factors for ESRD included non-white race (odds ratio for blacks, 5.5; 95% confidence interval, 3.8 to 8.0; odds ratio for other nonwhites, 3.5; 95% confidence interval, 1.2 to 10.0), categories of income (odds ratio gradient, 1.0 to 4.5; 95% confidence interval, 2.6 to 7.8), receipt of Medicaid benefits (odds ratio, 3.5; 95% confidence interval, 1.5 to 8.4), and number of missing teeth (odds ratio gradient, 1.0 to 2.2; 95% confidence interval, 1.2 to 4.1). Adjustment for socioeconomic variables reduced the odds ratio for blacks only partially, from 8.1 to 5.5. The proportions of ESRD incidence that could be attributed to each risk factor were 46% for minority race, 53% for income categories, and 33% for missing teeth. Low socioeconomic status and limited access to health care were strong risk factors for kidney failure, but they explained only part of the excess of ESRD in blacks. Racial and social factors account for a large part of ESRD incidence. The mechanisms of these associations should be targeted by further research.
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            Author and article information

            Journal
            NEF
            Nephron
            10.1159/issn.1660-8151
            Nephron
            S. Karger AG
            1660-8151
            2235-3186
            1998
            October 1998
            23 September 1998
            : 80
            : 2
            : 244-246
            Affiliations
            Departments of a Internal Medicine/Nephrology, b Public Health Sciences, and c Dermatology, Wake Forest University Baptist Medical Center, Winston-Salem, N.C., USA
            Article
            45181 Nephron 1998;80:244–246
            10.1159/000045181
            9736834
            © 1998 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Tables: 1, References: 17, Pages: 3
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/45181
            Categories
            Letter to the Editor

            Cardiovascular Medicine, Nephrology

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