Believing that assessments of changes in end-stage kidney disease (ESKD) incidence among Black and White Americans of different ages in recent decades were lacking, Chyng-Wen Fwu and fellow researchers analyzed United States Renal Data System data from 1980 to 2019 to determine ESKD incidence trends among Black and White Americans. They looked at adolescent (ages 13-17 years), adult (ages 18-64 years), and older adult (≥65 years) populations and used the National Cancer Institute Joinpoint Regression Program to estimate annual percent change in ESKD incidence and define points at which a statistically significant change in annual percent change slope occurred for each group.
They found that ESKD incidence for all groups increased after 1980, although trends differed (P<.001). By 1993, growth in incidence had slowed for most groups. By 2006, the annual percent change in ESKD incidence had decreased for all groups except White adults; their rates continued to increase (P<.05). Both Black and White adolescents experienced a return to near 1980 levels of ESKD incidence by 2019, but no other group’s rates improved to that degree. In every age group, ESKD incidence among Black individuals exceeded that of White individuals.
In summary, the investigators identified distinct patterns in ESKD incidence among patients of different ages, sexes, and races. These patterns may reflect access to preventive care, changes in dialysis acceptance rates, incidence of diabetes mellitus, implementation of evidence-based guidelines for CKD treatment, or other factors. There may be an opportunity to apply population-specific strategies to alter the growth of the ESKD patient population and address racial disparities.
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