End-stage renal disease in an osteopathic hemodialysis facility: A 10-year study

A retrospective 10-year study (March 1971 to April 1981) was undertaken at the Detroit Osteopathic Hospital chronic hemodialysis facility to determine the primary causes of chronic end-stage renal disease (ESRD), causes of death on hemodialysis, and cumulative patient survival while on dialysis in a predominantly inner-city patient population. The results revealed marked racial differences in the incidence of causes of ESRD with hypertensive nephrosclerosis most common in blacks (42 percent) and chronic glomerulonephritis (31.5 percent) in Caucasians. The most common cause of death was related to cardiovascular etiology (34 percent), but only 9.6 percent of the deaths could be attributed to documented acute myocardial infarction. The cumulative actuarial survival revealed 50 percent of patients to be alive after 25 months of dialysis. As expected, the worst survival was observed in the patients with diabetes mellitus as the cause of their renal failure (50 percent survival for 16 months). The implications of the racial differences in etiology of renal disease and the generally poor survival in the inner-city population of patients are discussed. The results of the data mostly compare favorably with other published statistics.