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BACKGROUND AND OBJECTIVES: Studies performed in the United States showed that blacks progress from CKD to ESRD faster than do whites. Possible explanations are differences in health care system factors. This study investigated whether progression is also faster in a universal health care system, where all patients receive comparable care. DESIGN, SETTING, PARTICIPANTS, whites: 13.1 IQR, 5.1 to 24.0). For blacks compared with whites, the crude HR for starting RRT within the first 15 months was 0.86 (95% confidence interval CI, 0.55 to 1.34) and from 15 months onward, 1.93 (95% CI, 1.02 to 3.68), which increased after adjustment. RFD was faster by 0.18 (95% CI, 0.05 to 0.32) ml/min per 1.73 m(2) per month in blacks compared with whites. CONCLUSION: Blacks receiving predialysis care in a universal health care system have faster disease progression than whites, suggesting that health care system factors have a less influential role than had been thought in explaining black-white differences.
Beukel et al. (Fri,) studied this question.