ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO1048

Racial Differences Among Recipients of Staff-Initiated CPR in Outpatient Dialysis Clinics

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Hofacker, Samuel A., Duke University School of Medicine, Durham, North Carolina, United States
  • Dupre, Matthew, Duke University School of Medicine, Durham, North Carolina, United States
  • Vellano, Kimberly, Emory University, Atlanta, Georgia, United States
  • Mcnally, Bryan, Emory University, Atlanta, Georgia, United States
  • Svetkey, Laura P., Duke University School of Medicine, Durham, North Carolina, United States
  • Pun, Patrick H., Duke University School of Medicine, Durham, North Carolina, United States
Background

Sudden cardiac arrest is the leading cause of death among hemodialysis patients. Despite practice guidelines recommending basic life support training for all hemodialysis clinic staff, rates of staff-initiated CPR are sub-optimal. Little is known about whether patient and clinic characteristics are associated with lower rates of dialysis staff-initiated CPR.

Methods

We examined data in the Cardiac Arrest Registry to Enhance Survival, a national surveillance registry with data submitted from 23 statewide registries and 70 additional communities, along with dialysis clinic data from the Centers for Medicare & Medicaid Services to identify cardiac arrests in outpatient hemodialysis clinics as well as characteristics of the rescue response between 2013 and 2017. Using multivariable logistic regression, we examined the likelihood of receiving dialysis staff-initiated CPR based on patient and dialysis clinic characteristics.

Results

Of the 1,581 patients who experienced cardiac arrest in hemodialysis clinics, 88.0% received staff-initiated CPR. 91.1% of White and 84.8% of Black patients received staff-initiated CPR (p=0.009). After accounting for patient age and sex, clinic characteristics, dialysis clinic neighborhood characteristics, and U.S. region (see Table), Black patients remained significantly less likely to receive staff-initiated CPR than White patients (aOR 0.45, 95% CI, 0.28 to 0.73). There was no relationship between patient race and dialysis staff automated external defibrillator application.

Conclusion

Black patients are significantly less likely than White patients to receive staff-initiated CPR during cardiac arrest in dialysis clinics across the US. Further understanding of resuscitation practices in dialysis clinics is necessary to address this finding.

Funding

  • NIDDK Support