Racial differences in incidence, outcome, and quality of life for African-Americans on hemodialysis.

African-Americans are the fastest growing racial minority with end-stage renal disease (ESRD) in the United States. Although comprising < 15% of the US population, African-Americans comprise approximately 31% of the ESRD population. African-Americans are approximately 7 years younger than their white counterparts with ESRD. Surprisingly, although African-Americans systematically receive less dialysis than whites, their survival with ESRD is greatly improved. This improved survival with ESRD is accompanied by an improved quality of life for African-Americans. In this review, we will examine the reasons why African-Americans have an excessive incidence of selective diseases that culminate in ESRD. Furthermore, we will judge several hypotheses that may account for the improved survival enjoyed by African-Americans with ESRD. We contend that research targeted to clarify the basis for these differences between African-Americans and whites with ESRD will improve the outcomes for both populations.