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Abstract: FR-PO831

Racial and Sex Disparities in Mortality in Incident ESRD Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
  • Leonard, Anthony C., University of Cincinnati, Cincinnati, Ohio, United States
  • Meganathan, Karthikeyan, University of Cincinnati, Cincinnati, Ohio, United States
  • Christianson, Annette, University of Cincinnati, Cincinnati, Ohio, United States
  • Thakar, Charuhas V., University of Cincinnati, Cincinnati, Ohio, United States
Background

End Stage Renal Disease (ESRD) is a global public health problem; and is characterized by high morbidity and mortality. Although mortality in patients is highest during the first year of dialysis, differences in mortality across five different races among men and women is not well studied.

Methods

We evaluated 944, 650 adult patients who initiated dialysis between 1/1/2005 and 12/31/2014 from the United States Renal Data System (USRDS). Using adjusted logistic multivariate regression models adjusted for major cofounders, we examined the effect of race and sex on all cause mortality after dialysis initiation.

Results

Mean age of the study population was 65±14 years. Of the study cohort, 56% were male. 53% were White, 28% were Black, 14% were Hispanic, 4% were Asian, and 1% were Native American. Of those who started dialysis, 77% initiated with a catheter. Overall, 30% did not receive pre-dialysis nephrology care. One-year mortality was 24% and 90-day mortality was 9%. In adjusted analyses, as compared to Whites, one-year mortality was lower among Blacks (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.72-0.74]), Hispanics (OR, 0.64; CI, 0.63-0.65), Asians (OR, 0.55; CI, 0.53-0.56), and Native Americans (OR, 0.67; CI, 0.63-0.71). Females were less likely to die within one year after initiating dialysis than were males (OR, 0.98; CI, 0.97-0.99). Other significant predictors of mortality included absence of predialysis nephrology care, use of central venous catheter as dialysis access, older age, poor functional status, serum albumin < 3.5 mg/dl, and comorbidities (congestive heart failure, cancer, and chronic obstructive pulmonary disease).

Conclusion

Among incident dialysis patients; as compared to White patients, Black patients are 27% less likely, Hispanic patients 36% less likely, Asians patients 45% less likely, and Native Americans are 33% less likely to die within one year. Females have lower mortality than males. Biological factors associated with these disparities need to be explored further to understand the reasons behind the survival advantage among minorities and women.