Abstract: SA-OR014

Racial and Ethnic Disparities in Access to Predialysis Nephrology Care in the US: Have We Made Any Progress over the Last Decade?

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 307 CKD: Health Services, Disparities, Prevention

Authors

  • Purnell, Tanjala S., Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Luo, Xun, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Bae, Sunjae, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Crews, Deidra C., Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Cooper, Lisa A., Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Segev, Dorry L., Johns Hopkins School of Medicine, Baltimore, Maryland, United States
Background

Over the past decade, there has been increased attention and efforts to improve overall access and redress racial and ethnic disparities in access to predialysis nephrology care in the US. The goal of this study was to investigate whether these efforts have been successful.

Methods

Using USRDS patient data, we performed multivariable logistic regression models to quantify temporal changes in racial and ethnic disparities in receipt of predialysis nephrology care among 934,599 adults who initiated chronic dialysis treatment between 2005 and 2015. We adjusted regression models for differences in patient sociodemographic factors.

Results

Over the last decade, racial and ethnic disparities in access to predialysis nephrology care slightly worsened. In 2005-2007, Blacks were 14% (aOR: 0.86, 95% CI: 0.85-0.88) and Hispanics were 22% (aOR: 0.78, 95% CI: 0.76-0.80) less likely to receive predialysis nephrology care than Whites. In 2008-2010, Blacks were 14% (aOR: 0.86, 95% CI: 0.84-0.87) and Hispanics were 29% (aOR: 0.71, 95% CI: 0.70-0.73) less likely than Whites. In 2011-2013, Blacks were 18% (aOR: 0.82, 95% CI: 0.81-0.84) and Hispanics were 30% (aOR: 0.70, 95% CI: 0.69-0.72) less likely than Whites. In 2014-2015, Blacks were 19% (aOR: 0.81, 95% CI: 0.79-0.83) and Hispanics were 29% (aOR: 0.71, 95% CI: 0.69-0.73) less likely than Whites. (Figure 1)

Conclusion

Disparities in access to predialysis nephrology care worsened (versus narrowed) over the past decade. Targeted interventions to effectively reduce these disparities should be identified and adopted widespread to improve outcomes for patients with ESRD in the US.

Funding

  • NIDDK Support