Abstract: FR-OR075
Racial Disparities in In-Hospital Outcomes and Health Care Costs Among Patients with ESKD on Peritoneal Dialysis: A 15-Year National Analysis
Session Information
- What's New at Home (Dialysis)?
November 07, 2025 | Location: Room 351D, Convention Center
Abstract Time: 04:50 PM - 05:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Arriola Montenegro, Jose J, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Thongprayoon, Charat, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
- Suppadungsuk, Supawadee, Chakri Naruebodindra Medical Institute, Bang Pla, Thailand
- Wathanavasin, Wannasit, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Ordaya Gonzales, Karina M, Universidad Cientifica del Sur Facultad de Ciencias de la Salud, Lima, Peru
- Cheungpasitporn, Wisit, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
Background
Racial disparities in in-hospital treatment and outcomes among end-stage kidney disease (ESKD) patients receiving peritoneal dialysis (PD) are not well-characterized. This study aims to assess racial differences in treatment, complications, and resource utilization among hospitalized ESKD patients undergoing PD.
Methods
A retrospective cohort study was conducted using the National Inpatient Sample from 2003 to 2018, including 82,704 hospitalized ESKD patients receiving PD. Racial groups were categorized as White, Black, Hispanic, and Asian/Pacific Islander. Logistic regression was used to evaluate associations between race and in-hospital treatments, complications, and outcomes. Linear regression assessed racial differences in hospitalization costs. Models were adjusted for age, sex, comorbidities, hospital characteristics, and primary insurance.
Results
Of 82,704 patients, 53.9% were White, 28.5% Black, 13.3% Hispanic, and 4.3% Asian/Pacific Islander. Compared with White patients, Black patients had higher odds for PD catheter adjustment/removal (OR 1.14), PD peritonitis (OR 1.22), and volume overload (OR 1.21) but lower odds for palliative care (OR 0.69) and in-hospital mortality (OR 0.83). Hispanic patients had higher odds for PD peritonitis (OR 1.09) and sepsis (OR 1.09) but lower odds for metabolic acidosis (OR 0.89) and palliative care (OR 0.61). Asian/Pacific Islanders had higher odds for mechanical ventilation (OR 1.29) and sepsis (OR 1.26) but lower odds for hyperkalemia (OR 0.88). Hospitalization costs were lower for Black patients but higher for Hispanic and Asian/Pacific Islander patients.
Conclusion
Racial disparities in in-hospital treatment and outcomes exist among ESKD patients receiving PD, with Black patients experiencing lower mortality despite more complications and lower resource utilization, while Hispanic and Asian/Pacific Islander patients encounter higher costs and complications. Interventions targeting racial disparities in PD care are warranted.