Racial and ethnic disparities in use of and outcomes with home dialysis in the United States

Rajnish Mehrotra, Melissa Soohoo, Matthew B. Rivara, Jonathan Himmelfarb, Alfred K. Cheung, Onyebuchi A. Arah, Allen R. Nissenson, Vanessa Ravel, Elani Streja, Sooraj Kuttykrishnan, Ronit Katz, M. Molnár, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Home dialysis, which comprises peritoneal dialysis (PD) or home hemodialysis (home HD), offers patients with ESRD greater flexibility and independence. Although ESRD disproportionately affects racial/ethnic minorities, data on disparities in use and outcomes with home dialysis are sparse. We analyzed data of patients who initiated maintenance dialysis between 2007 and 2011 and were admitted to any of 2217 dialysis facilities in 43 states operated by a single large dialysis organization, with follow-up through December 31, 2011 (n=162,050, of which 17,791 underwent PD and 2536 underwent home HD for ≥91 days). Every racial/ethnic minority group was significantly less likely to be treated with home dialysis than whites. Among individuals treated with in-center HD or PD, racial/ethnic minorities had a lower risk for death than whites; among individuals undergoing home HD, only blacks had a significantly lower death risk than whites. Blacks undergoing PD or home HD had a higher risk for transfer to in-center HD than their white counterparts, whereas Asians or others undergoing PD had a lower risk than whites undergoing PD. Blacks irrespective of dialysis modality, Hispanics undergoing PD or in-center HD, and Asians and other racial groups undergoing in-center HD were significantly less likely than white counterparts to receive a kidney transplant. In conclusion, there are racial/ethnic disparities in use of and outcomes with home dialysis in the United States. Disparities in kidney transplantation evident for blacks and Hispanics undergoing home dialysis are similar to those with in-center HD. Future studies should identify modifiable causes for these disparities.

Original languageEnglish
Pages (from-to)2123-2134
Number of pages12
JournalJournal of the American Society of Nephrology
Volume27
Issue number7
DOIs
Publication statusPublished - Jan 1 2016

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Dialysis
Peritoneal Dialysis
Home Hemodialysis
Hispanic Americans
Chronic Kidney Failure
Minority Groups
Ethnic Groups
Kidney Transplantation
Maintenance
Organizations
Transplants
Kidney

ASJC Scopus subject areas

  • Nephrology

Cite this

Mehrotra, R., Soohoo, M., Rivara, M. B., Himmelfarb, J., Cheung, A. K., Arah, O. A., ... Kalantar-Zadeh, K. (2016). Racial and ethnic disparities in use of and outcomes with home dialysis in the United States. Journal of the American Society of Nephrology, 27(7), 2123-2134. https://doi.org/10.1681/ASN.2015050472

Racial and ethnic disparities in use of and outcomes with home dialysis in the United States. / Mehrotra, Rajnish; Soohoo, Melissa; Rivara, Matthew B.; Himmelfarb, Jonathan; Cheung, Alfred K.; Arah, Onyebuchi A.; Nissenson, Allen R.; Ravel, Vanessa; Streja, Elani; Kuttykrishnan, Sooraj; Katz, Ronit; Molnár, M.; Kalantar-Zadeh, Kamyar.

In: Journal of the American Society of Nephrology, Vol. 27, No. 7, 01.01.2016, p. 2123-2134.

Research output: Contribution to journalArticle

Mehrotra, R, Soohoo, M, Rivara, MB, Himmelfarb, J, Cheung, AK, Arah, OA, Nissenson, AR, Ravel, V, Streja, E, Kuttykrishnan, S, Katz, R, Molnár, M & Kalantar-Zadeh, K 2016, 'Racial and ethnic disparities in use of and outcomes with home dialysis in the United States', Journal of the American Society of Nephrology, vol. 27, no. 7, pp. 2123-2134. https://doi.org/10.1681/ASN.2015050472
Mehrotra, Rajnish ; Soohoo, Melissa ; Rivara, Matthew B. ; Himmelfarb, Jonathan ; Cheung, Alfred K. ; Arah, Onyebuchi A. ; Nissenson, Allen R. ; Ravel, Vanessa ; Streja, Elani ; Kuttykrishnan, Sooraj ; Katz, Ronit ; Molnár, M. ; Kalantar-Zadeh, Kamyar. / Racial and ethnic disparities in use of and outcomes with home dialysis in the United States. In: Journal of the American Society of Nephrology. 2016 ; Vol. 27, No. 7. pp. 2123-2134.
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