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Abstract: SA-PO1052

Characteristics and Outcomes of Hemodialysis Patients by Population Density

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ash, Brian Scott, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Lindsay, Janice D., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Population density associates with distinct profiles of health in the general population. Patients undergoing hemodialysis (HD) could be affected by the urbanicity level of their residence. We classified the characteristics and outcomes of HD patients at a large dialysis organization (LDO) by population density.

Methods

We analyzed 2018 data from HD patients. They were classified according to the county level population density defined by the Rural Institute, University of Montana: i) Metropolitan: ≥50,000 residents with integration to adjacent counties; ii) Micropolitan: ≥10,000-50,000 residents with integration to neighboring counties; iii) Rural: <10,000 residents. Median income data was obtained from the US Census database. We defined the profiles of demographics, clinical characteristics, and outcomes by level of population density.

Results

We analyzed data on 254322 HD patients. Of those, 84% resided in a metropolitan county, 10% lived in a micropolitan county, and 6% resided in a rural county. Average age was 64 years old in all population densities. More females lived in an urban county (44% vs 42% and 42% in metropolitan, micropolitan and rural counties, respectively). White race varied from 49%-52% and was the highest in micropolitan and lowest in metropolitan counties. Metropolitan areas had the highest proportion of Hispanics (13% vs 7% and 5% in metropolitan, micropolitan and rural counties). Median income was the highest in metropolitan areas ($54883 vs $43060 and $39630 in metropolitan, micropolitan and rural). In metropolitan to rural counties, the prevalence of comorbid conditions varied from 67-69% for diabetes, 19-22% for congestive heart failure, and 19-23% ischemic heart disease. In rural counties, patients less commonly received an extra HD treatment each week (7%, 7%, and 5% in metropolitan, micropolitan and rural). Hospital admission rates were higher in metropolitan areas (1.8 vs 1.7 and 1.7 admissions per patient year in metropolitan, micropolitan and rural).

Conclusion

Our findings suggest the characteristics and outcomes of HD patients vary by the population density of their residence. Further analyses are needed to understand the influence of practice patterns, access to health care, and distinctions in demographics on patient outcomes.

Funding

  • Commercial Support