![]() In contrast to systematic reviews, scoping reviews identify and synthesise the breadth of knowledge in a given area without in depth assessment of study quality. A scoping review rapidly examines the extent, range, and nature of existing knowledge in a diverse body of literature, summarises research findings and identifies research gaps. Furthermore, no studies have systematically synthesised evidence for ethnic differences in mortality for people with pre-dialysis CKD, which would further contribute to understanding of ethnic differences in CKD progression – a competing risk. However, there have since been further studies in the field. A systematic review published in 2010 that investigated ethnic differences in CKD progression, and had similar inclusion criteria to the current study, identified 5 relevant studies and concluded little evidence for ethnic differences in CKD progression and a lack of appropriately designed studies to assess ethnic differences in CKD progression. To our knowledge, no study has systematically scoped studies exploring the range of risk factors for ethnic differences in CKD progression and mortality. Understanding which ethnic groups have worse outcomes and which factors influence adverse outcomes can help clinicians and policy makers target health care efforts and resources and improve outcomes for individuals, as well as inform policies to reduce health inequities. Higher RRT prevalence in ethnic minority groups has been attributed to faster progression of CKD and better CKD survival. In the United States (US), the rate of RRT initiation for end-stage kidney disease (ESKD) is also disproportionately higher for ethnic minority groups (such as African-American, Hispanic and Native Americans) compared to Caucasians, despite similar prevalence for early stages of CKD. In the UK, a higher proportion of people from ethnic minority groups than Caucasians begin renal replacement therapy (RRT). Risk factors for progression include proteinuria, comorbid conditions such as diabetes and cardiovascular disease, as well as non-modifiable characteristics such as ethnicity. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.Ĭhronic kidney disease (CKD) is common and is associated with increased morbidity and mortality. Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. ![]() ![]() ResultsĨ059 articles were identified and screened. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. There are a growing number of studies on ethnic differences in progression and mortality for pre-dialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |