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Kidney Week

Abstract: SA-PO055

Disparities in Home Dialysis for Latinx People with Kidney Disease: A National Qualitative Study of Dialysis Social Workers

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Rizzolo, Katherine M., Boston Medical Center, Boston, Massachusetts, United States
  • Cervantes, Lilia, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
Background

Latinx people have a 2.1 fold higher incidence rate of kidney failure compared to non-Latinx White individuals, yet are less likely to use home dialysis. This discrepancy has not been completely explained by medical, socioeconomic, or demographic variables. Improving access to home dialysis is a priority of the Advancing American Kidney Health Initiative, a 2019 executive order to transform kidney disease care for individuals in the US. Dialysis social workers play a crucial role in home dialysis assessment and education. In this study, we utilized qualitative interviews with dialysis social workers across the US to better understand the facilitators and barriers to home dialysis for Latinx patients with kidney failure.

Methods

We conducted a qualitative study with adult (age >18) dialysis social workers in the US with experience working with Latinx populations. The semi structured interview guide included open ended questions exploring dialysis modality education, dialysis decision making, and home dialysis uptake and maintenance. Interviews were audio-recorded, transcribed verbatim, de-identified and transcripts were analyzed independently by two members utilizing thematic analysis.

Results

We interviewed 20 dialysis social workers from ten different states, with a median age range of 30-40 (35%), 100% female, 14 (70%) identified as White and 5 (25%) of participants spoke Spanish. Participants described five themes affecting home modality access for Latinx people: 1) Variation in modality education 2) Evaluating candidacy for home dialysis 3) Role of language and communication 4) Facilitators to home dialysis and 5) Barriers to home dialysis (Table)

Conclusion

Our study illustrates early language and culture concordant education is critical for home modality uptake amongst Latinx people with kidney disease. Involving the social worker early in the home dialysis is critical for evaluating for important issues that may affect home dialysis treatment.

Funding

  • NIDDK Support