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Race and Dialysis Survival-Reply

William M. Tierney, MD, FACP; Lisa E. Harris, MD
Arch Intern Med. 1992;152(4):879-880. doi:10.1001/archinte.1992.00400160159035.
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In Reply. —  We welcome Bleyer's letter as it gives us the opportunity to correct the error in our original editorial.1 Black Americans undergoing dialysis do have a better survival rate than white patients. The error was due to misinterpretation of the text and tables in reference 23 in our editorial.2 We do not believe that the error in any way detracts from the message that we wished to convey in the editorial, ie, that black patients suffer more from end-stage renal disease even after correcting for clinical, demographic, and socioeconomic variables.Like Bleyer, we have also speculated on why black patients undergoing dialysis would have better survival rates. Bleyer argues that it is unlikely that this better outcome is due to better care for black patients than for white patients and he offers clinical reasons why blacks survive longer. He postulates that blacks undergoing dialysis are less


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