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dc.contributor.authorWolf, Myles
dc.contributor.authorBetancourt, Joseph
dc.contributor.authorChang, Yuchiao
dc.contributor.authorShah, Anand
dc.contributor.authorTeng, Ming
dc.contributor.authorTamez, Hector
dc.contributor.authorGutierrez, Orlando
dc.contributor.authorCamargo, Carlos A. Jr.
dc.contributor.authorMelamed, Michal
dc.contributor.authorNorris, Keith
dc.contributor.authorStampfer, Meir
dc.contributor.authorPowe, Neil R.
dc.contributor.authorThadhani, Ravi
dc.date.accessioned2019-09-06T14:15:08Z
dc.date.issued2008
dc.identifier.citationWolf, Myles, Joseph Betancourt, Yuchiao Chang, Anand Shah, Ming Teng, Hector Tamez, Orlando Gutierrez, et al. 2008. “Impact of Activated Vitamin D and Race on Survival among Hemodialysis Patients.” Journal of the American Society of Nephrology 19 (7): 1379–88. https://doi.org/10.1681/asn.2007091002.
dc.identifier.issn1046-6673
dc.identifier.issn1533-3450
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41292852*
dc.description.abstractContrary to most examples of disparities in health outcomes, black patients have improved survival compared with white patients after initiating hemodialysis. Understanding potential explanations for this observation may have important clinical implications for minorities in general. This study tested the hypothesis that greater use of activated vitamin D therapy accounts for the survival advantage observed in black and Hispanic patients on hemodialysis. In a prospective cohort of non-Hispanic white (n = 5110), Hispanic white (n = 979), and black (n = 3214) incident hemodialysis patients, higher parathyroid hormone levels at baseline were the primary determinant of prescribing activated vitamin D therapy. Median parathyroid hormone was highest among black patients, who were most likely to receive activated vitamin D and at the highest dosage. One-year mortality was lower in black and Hispanic patients compared with white patients (16 and 16 versus 23%; P < 0.01), but there was significant interaction between race and ethnicity, activated vitamin D therapy, and survival. In multivariable analyses of patients treated with activated vitamin D, black patients had 16% lower mortality compared with white patients, but the difference was lost when adjusted for vitamin D dosage. In contrast, untreated black patients had 35% higher mortality compared with untreated white patients, an association that persisted in several sensitivity analyses. In conclusion, therapy with activated vitamin D may be one potential explanation for the racial differences in survival among hemodialysis patients. Further studies should determine whether treatment differences based on biologic differences contribute to disparities in other conditions.
dc.language.isoen_US
dc.publisherAmerican Society of Nephrology
dash.licenseMETA_ONLY
dc.titleImpact of Activated Vitamin D and Race on Survival among Hemodialysis Patients
dc.typeJournal Article
dc.description.versionVersion of Record
dc.relation.journalJournal of the American Society of Nephrology - JASN
dash.depositing.authorStampfer, Meir
dc.date.available2019-09-06T14:15:08Z
dash.workflow.comments1Science Serial ID 56727
dc.identifier.doi10.1681/ASN.2007091002
dash.source.volume19;7
dash.source.page1379
dash.contributor.affiliatedStampfer, Meir


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