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

PLoS One. 2016 May 19;11(5):e0155271. doi: 10.1371/journal.pone.0155271. eCollection 2016.


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.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • End Stage Liver Disease / ethnology*
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Phosphates / blood
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis / methods*
  • Risk Factors
  • Roma
  • Romania
  • Serum Albumin / chemistry
  • Time Factors
  • Treatment Outcome


  • Phosphates
  • Serum Albumin

Grant support

This research project was funded by an internal grant from the University of Medicine and Pharmacy ‘‘Victor Babes’’ Timisoara, PIII-C2-PCFI-2015/2016, AS received the funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.