There are a growing number of studies on ethnic differences in progression and mortality for pre-dialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality. This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020. 8059 articles were identified and screened. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups. Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.

中文翻译：

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透析前慢性肾病进展和死亡率的少数民族差异：系统范围审查。

越来越多的关于透析前慢性肾脏病 (CKD) 进展和死亡率的种族差异的研究，但这些文献尚未综合，特别是关于死亡率的研究。本范围审查综合了关于透析前 CKD 成人进展和死亡率种族差异的现有文献，探讨了导致这些差异的因素，并确定了文献中的差距。使用种族和 CKD 搜索词的综合搜索策略被用来识别潜在的相关研究。从 1992 年到 2017 年 6 月检索了 9 个数据库，并在 2020 年 2 月进行了更新检索。确定并筛选了 8059 篇文章。本综述纳入了 55 项研究（2 项系统评价、7 项非系统评价和 46 项单项研究）。大多数是美国研究，并比较了非洲裔美国人/非洲裔加勒比人和白种人人群，而很少有研究评估西班牙裔人和亚洲人的结果。大多数研究报告称，与白种人相比，加勒比黑人/非裔美国人、西班牙裔美国人和亚洲人的 CKD 进展风险更高，亚洲人的死亡风险更低，并且对非裔加勒比人/非洲裔美国人和西班牙裔美国人的死亡风险的研究结果喜忧参半. 高血压、糖尿病和心血管疾病等生物学因素导致少数族裔疾病进展风险增加，但并未增加这些群体的死亡风险。少数族裔中较高的肾脏替代治疗率可能部分是由于这些群体的进展风险增加和死亡率降低。