decades beginning in 1980. Growth in incidence slowed for most groups by 1993, and by 2006, the annual percent change (APC) in ESKD incidence had declined for all groups, except White adults, for whom rates continued to rise. By 2019, ESKD incidence among Black and White adolescents nearly returned to 1980 levels, but no other group achieved that degree of improvement. Nonetheless, the ESKD incidence rate among Black American patients exceeds that of White patients in every age group. Distinct patterns in ESKD incidence among patients of different age, sex, and racial groups are shown. These findings could reflect changes in dialysis acceptance rates, access to preventive health care, incidence of diabetes mellitus, implementation of evidence-based guidelines for treatment of CKD, or other unrecognized factors. There may be population-specific opportunities to change the growth of the US ESKD population and address current racial disparities. Background Substantial changes in ESKD incidence over four decades among Black and White Americans of different ages have been incompletely explored. Methods We analyzed United States Renal Data System data from 1980 to 2019 to determine ESKD incidence trends among Black and White adolescent (13–17 years), adult (18–64 years), and older adult (≥65) populations. We used the National Cancer Institute Joinpoint Regression Program to estimate annual percent change (APC) in ESKD incidence and to define points in time where a statistically significant change in APC slope occurred for each group. Results ESKD incidence rose after 1980 for all groups, although the trends differed (P < 0.001). Growth in incidence slowed for most by 1993, and by 2006, the APC in ESKD incidence had declined for all groups, except White adults, for whom rates continued to rise (P < 0.05). By 2019, ESKD incidence among Black and White adolescents nearly returned to 1980 levels, but no other group achieved that degree of improvement. Nonetheless, the ESKD incidence among Black American patients exceeds that of White patients in every age group. Conclusions Distinct patterns in ESKD incidence among patients of different age, sex, and racial groups are shown. These findings could reflect changes in dialysis acceptance rates, access to preventive health care, incidence of diabetes mellitus, implementation of evidence-based guidelines for treatment of CKD, or other unrecognized factors. Podcast This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2024_03_13_ASN0000000000000310.mp3...

中文翻译：

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过去 40 年中 ESKD 发病率的年龄和种族特定变化

从 1980 年开始的几十年中。到 1993 年，大多数群体的发病率增长放缓，到 2006 年，所有群体的 ESKD 发病率年度百分比变化 (APC) 均下降，但白人成年人除外，白人成年人的发病率持续上升。到 2019 年，黑人和白人青少年的 ESKD 发病率几乎恢复到 1980 年的水平，但没有其他群体达到这种程度的改善。尽管如此，美国黑人患者中各个年龄段的 ESKD 发病率均超过白人患者。显示了不同年龄、性别和种族群体的患者中 ESKD 发病率的不同模式。这些发现可能反映了透析接受率、获得预防性医疗保健的机会、糖尿病发病率、慢性肾病治疗循证指南的实施或其他未识别因素的变化。可能存在针对特定人群的机会来改变美国 ESKD 人口的增长并解决当前的种族差异。背景 四十年来不同年龄的美国黑人和白人中 ESKD 发病率的实质性变化尚未得到完全探索。方法 我们分析了 1980 年至 2019 年美国肾脏数据系统的数据，以确定黑人和白人青少年（13-17 岁）、成人（18-64 岁）和老年人（≥65 岁）人群中 ESKD 的发病趋势。我们使用国家癌症研究所连接点回归程序来估计 ESKD 发病率的年度百分比变化 (APC)，并定义每组 APC 斜率发生统计显着变化的时间点。结果 1980 年之后，所有群体的 ESKD 发病率均有所上升，但趋势有所不同 (P < 0.001)。到 1993 年，大多数人的发病率增长放缓，到 2006 年，所有群体的 ESKD 发病率 APC 均下降，但白人成年人除外，白人成年人的发病率继续上升（P < 0.05）。到 2019 年，黑人和白人青少年的 ESKD 发病率几乎恢复到 1980 年的水平，但没有其他群体达到这种程度的改善。尽管如此，美国黑人患者中各年龄组的 ESKD 发病率均超过白人患者。结论 不同年龄、性别和种族群体的 ESKD 发病率存在不同的模式。这些发现可能反映了透析接受率、获得预防性医疗保健的机会、糖尿病发病率、慢性肾病治疗循证指南的实施或其他未识别因素的变化。播客 本文包含一个播客，网址为 https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2024_03_13_ASN0000000000000310.mp3...