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Abstract: PO1183

Native Hawaiian/Pacific Islander Data in the USRDS

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Gilbertson, David T., Chronic Disease Research Group, Minneapolis, MN, US, Minneapolis, Minnesota, United States
  • Wetmore, James B., Chronic Disease Research Group, Minneapolis, MN, US, Minneapolis, Minnesota, United States
  • Peng, Yi, Chronic Disease Research Group, Minneapolis, MN, US, Minneapolis, Minnesota, United States
  • Liu, Jiannong, Chronic Disease Research Group, Minneapolis, MN, US, Minneapolis, Minnesota, United States
  • Johansen, Kirsten L., Chronic Disease Research Group, Minneapolis, MN, US, Minneapolis, Minnesota, United States
Background

The United States Renal Data System (USRDS) has reported very high ESRD incidence and prevalence rates among patients designated as Native Hawaiian or Other Pacific Islander (NH/PI) race. Xiang et al. (2019 NKF Spring Clinical Meeting) reported a “denominator problem,” caused by a large percentage of NH/PI individuals reporting multiple races in the US census. By counting only single-race individuals, resulting dominators are too small, leading to rates that appear to be too large. We sought to assess whether reporting of race is accurate for these individuals by examining reported country of origin on the CMS 2728 Medical Evidence (ME) form.

Methods

Using data from the ME form for patients initiating dialysis in 2016, we examined the accuracy of the country/area of origin field, which is required to be filled out only when NH/PI race is chosen. We assumed all those reporting the US as the country of origin were correct.

Results

The figure displays country/area of origin or ancestry for the 1578 patients who reported NH/PI race, for the top 25 countries, which accounts for 90.8% of all NH/PI patients. Only 58.7% of them came from countries that are actually part of the census definition of NH/PI. The largest misclassified countries were Philippines (19.2%) and Mexico (2.5%).

Conclusion

The apparently high rates of ESRD among NH/PI individuals have gained increasing attention. Our finding of inaccurate understanding of the US census definition of NH/PI leading to numerators of rates that are too large, combined with the already important problem of the US census single vs. multiple race denominator, makes it difficult and perhaps even impossible to calculate accurate incidence and prevalence rates for this race group. Improvements in capturing accurate race information at the time of ESRD initiation are needed.

Funding

  • NIDDK Support