The Survival of Roma Minority Patients on Chronic Hemodialysis Therapy - A Romanian Multicenter Survey.

Florica Gadalean, Daniel Lighezan, Dana Stoian, Oana Schiller, Romulus Timar, Bogdan Timar, Flaviu Bob, Mihaela Dora Donciu, Mircea Munteanu, Adelina Mihaescu, Adrian Covic, Adalbert Schiller

Journal: PloS one 2017;11(5):e0155271

PMID: 27196564

Abstract

OBJECTIVE

The Roma minority represents the largest ethnic group in Central and South-East European countries. Data regarding the mortality in Roma hemodialysis subjects are limited. We evaluated the 3 year mortality of ESRD Roma patients treated with hemodialysis (HD).

STUDY DESIGN AND SETTING

Our prospective cohort study included 600 ESRD patients on HD therapy recruited from 7 HD centers, from the main geographical regions of Romania. The median age of the patients was 56 (19) years, 332 (55.3%) being males, 51 (8.5%) having Roma ethnicity.

RESULTS

Roma ESRD patients initiate dialysis at a younger age, 47.8 years vs. 52.3 years (P = 0.017), present higher serum albumin (P = 0.013) and higher serum phosphate levels (P = 0.021). In the Roma group, the overall 3 year mortality was higher when compared to Caucasians (33.3% vs. 24.8%). The multivariate survival analysis revealed that being of Roma ethnicity is an independent risk factor for mortality (HR = 1.74; 95% CI = 1.04-2.91; P = 0.035).

CONCLUSIONS

Roma patients with ESRD initiate HD therapy at a younger age as compared to Caucasians. They have a higher 3 year mortality rate and are dying at a younger age. Roma ethnicity represents an independent risk factor for mortality in our cohort.

Address: Department of Nephrology, 'Victor Babes' University of Medicine and Pharmacy, County Emergency Hospital, Timisoara, Romania.; Department of Internal Medicine, 'Victor Babes' University of Medicine and Pharmacy, Municipal Clinical Emergency Hospital, Timisoara, Romania.; Department of Obstetrics and Gynecology, 'Victor Babes' University of Medicine and Pharmacy, Municipal Hospital, Timisoara, Romania.; B Braun Avitum Dialysis Center Timisoara, Timisoara, Romania.; Department of Diabetes and Metabolic Diseases, 'Victor Babes' University of Medicine and Pharmacy, County Emergency Hospital, Timisoara, Romania.; Department of Medical Informatics and Biostatistics, 'Victor Babes' University of Medicine and Pharmacy, County Emergency Hospital, Timisoara, Romania.; Department of Nephrology and Internal Medicine, University of Medicine "Gr. T. Popa" Iasi, Hospital "C. I. Parhon" Iasi, Iasi, Romania.
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