Outcomes of renal replacement therapy among blacks and women.

The outcomes of renal replacement therapy differ dramatically by race and gender. Compared with white patients, black patients have poorer outcomes in five clinical parameters (anemia, hypertension, vascular access, adequacy of dialysis, compliance), employment, and access to transplantation. Compared with males, females have poorer outcomes in hospitalization, three clinical parameters (anemia, vascular access, nutrition), quality of life, and access to transplantation. Despite several poorer intermediate outcomes, blacks and women do better than whites and men in survival. Eliminating racial and gender differences in outcomes of renal replacement therapy requires that we (1) become aware of such differences, (2) determine barriers to optimal outcomes, and (3) develop interventions to overcome these barriers. This approach can lead to improved outcomes not just among blacks and women but among all renal patients. Examining racial and gender differences can also lead to an increased understanding of renal disease.