Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States

Diane L. Frankenfield, Sylvia P B Ramirez, William M. McClellan, Pamela R. Frederick, Michael V. Rocco

Research output: Contribution to journalArticle

Abstract

Background. There is a paucity of information regarding the clinical experience of Asian hemodialysis patients. This paper describes intermediate outcomes for adult Asian hemodialysis patients compared to Caucasians and African Americans. Methods. Dialysis facility staff abstracted clinical information on a national random sample of adult hemodialysis patients from October through December 2000. Associations of race with intermediate outcomes were tested by bivariate analyses and multivariable logistic regression modeling. Results. A total of 429 patients were identified as Asian, 4403 as Caucasians, and 3103 as African Americans. Asian and Caucasian patients were older than African Americans [mean 63.2 (±15.6), 63.9 (±15.2), and 57.7 (±14.7) years, P <0.001], and had fewer years on dialysis [mean 3.5 (±3.8), 3.1 (±3.8), and 4.1 (±4.1) years, P <0.001]. Ninety three percent of Asians, 87% of Caucasians, and 84% of African Americans had a mean Kt/V ≥1.2 (P <0.001). In addition, 36% of Asians, 32% of Caucasians, and 26% of African Americans had an arteriovenous (AV) fistula as their vascular access (P <0.001). Hemoglobin profiles were only slightly different among the three racial groups. More Asians and African Americans had a mean serum albumin ≥4.0/3.7 g/dL compared to Caucasians (33% and 31% compared to 27%, respectively, P <0.001). In the final multivariable logistic regression model, Asians were twice as likely to have a mean Kt/V ≥1.2 compared to Caucasians (the referent group) [odds ratio (OR) (95% CI) 2.10 (1.33, 3.32), P <0.01]. They experienced similar intermediate outcomes for vascular access, anemia management, and serum albumin compared to the majority racial group. Conclusion. These findings indicate that adult hemodialysis Asian patients experience similar or better intermediate outcomes compared to the majority racial group. Further study is needed to determine if these results are associated with improved survival and less morbidity in this minority group.

Original languageEnglish (US)
Pages (from-to)623-631
Number of pages9
JournalKidney International
Volume64
Issue number2
DOIs
StatePublished - Aug 1 2003

Fingerprint

African Americans
Renal Dialysis
Logistic Models
Serum Albumin
Blood Vessels
Dialysis
Minority Groups
Asian Americans
Arteriovenous Fistula
Anemia
Hemoglobins
Odds Ratio
Morbidity
Survival

Keywords

  • Asian
  • Intermediate outcomes
  • Race

ASJC Scopus subject areas

  • Nephrology

Cite this

Frankenfield, D. L., Ramirez, S. P. B., McClellan, W. M., Frederick, P. R., & Rocco, M. V. (2003). Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States. Kidney International, 64(2), 623-631. https://doi.org/10.1046/j.1523-1755.2003.00121.x

Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States. / Frankenfield, Diane L.; Ramirez, Sylvia P B; McClellan, William M.; Frederick, Pamela R.; Rocco, Michael V.

In: Kidney International, Vol. 64, No. 2, 01.08.2003, p. 623-631.

Research output: Contribution to journalArticle

Frankenfield, Diane L. ; Ramirez, Sylvia P B ; McClellan, William M. ; Frederick, Pamela R. ; Rocco, Michael V. / Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States. In: Kidney International. 2003 ; Vol. 64, No. 2. pp. 623-631.
@article{55ab5b20aec64347adfc722d2f8e82ed,
title = "Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States",
abstract = "Background. There is a paucity of information regarding the clinical experience of Asian hemodialysis patients. This paper describes intermediate outcomes for adult Asian hemodialysis patients compared to Caucasians and African Americans. Methods. Dialysis facility staff abstracted clinical information on a national random sample of adult hemodialysis patients from October through December 2000. Associations of race with intermediate outcomes were tested by bivariate analyses and multivariable logistic regression modeling. Results. A total of 429 patients were identified as Asian, 4403 as Caucasians, and 3103 as African Americans. Asian and Caucasian patients were older than African Americans [mean 63.2 (±15.6), 63.9 (±15.2), and 57.7 (±14.7) years, P <0.001], and had fewer years on dialysis [mean 3.5 (±3.8), 3.1 (±3.8), and 4.1 (±4.1) years, P <0.001]. Ninety three percent of Asians, 87{\%} of Caucasians, and 84{\%} of African Americans had a mean Kt/V ≥1.2 (P <0.001). In addition, 36{\%} of Asians, 32{\%} of Caucasians, and 26{\%} of African Americans had an arteriovenous (AV) fistula as their vascular access (P <0.001). Hemoglobin profiles were only slightly different among the three racial groups. More Asians and African Americans had a mean serum albumin ≥4.0/3.7 g/dL compared to Caucasians (33{\%} and 31{\%} compared to 27{\%}, respectively, P <0.001). In the final multivariable logistic regression model, Asians were twice as likely to have a mean Kt/V ≥1.2 compared to Caucasians (the referent group) [odds ratio (OR) (95{\%} CI) 2.10 (1.33, 3.32), P <0.01]. They experienced similar intermediate outcomes for vascular access, anemia management, and serum albumin compared to the majority racial group. Conclusion. These findings indicate that adult hemodialysis Asian patients experience similar or better intermediate outcomes compared to the majority racial group. Further study is needed to determine if these results are associated with improved survival and less morbidity in this minority group.",
keywords = "Asian, Intermediate outcomes, Race",
author = "Frankenfield, {Diane L.} and Ramirez, {Sylvia P B} and McClellan, {William M.} and Frederick, {Pamela R.} and Rocco, {Michael V.}",
year = "2003",
month = "8",
day = "1",
doi = "10.1046/j.1523-1755.2003.00121.x",
language = "English (US)",
volume = "64",
pages = "623--631",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "2",

}

TY - JOUR

T1 - Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States

AU - Frankenfield, Diane L.

AU - Ramirez, Sylvia P B

AU - McClellan, William M.

AU - Frederick, Pamela R.

AU - Rocco, Michael V.

PY - 2003/8/1

Y1 - 2003/8/1

N2 - Background. There is a paucity of information regarding the clinical experience of Asian hemodialysis patients. This paper describes intermediate outcomes for adult Asian hemodialysis patients compared to Caucasians and African Americans. Methods. Dialysis facility staff abstracted clinical information on a national random sample of adult hemodialysis patients from October through December 2000. Associations of race with intermediate outcomes were tested by bivariate analyses and multivariable logistic regression modeling. Results. A total of 429 patients were identified as Asian, 4403 as Caucasians, and 3103 as African Americans. Asian and Caucasian patients were older than African Americans [mean 63.2 (±15.6), 63.9 (±15.2), and 57.7 (±14.7) years, P <0.001], and had fewer years on dialysis [mean 3.5 (±3.8), 3.1 (±3.8), and 4.1 (±4.1) years, P <0.001]. Ninety three percent of Asians, 87% of Caucasians, and 84% of African Americans had a mean Kt/V ≥1.2 (P <0.001). In addition, 36% of Asians, 32% of Caucasians, and 26% of African Americans had an arteriovenous (AV) fistula as their vascular access (P <0.001). Hemoglobin profiles were only slightly different among the three racial groups. More Asians and African Americans had a mean serum albumin ≥4.0/3.7 g/dL compared to Caucasians (33% and 31% compared to 27%, respectively, P <0.001). In the final multivariable logistic regression model, Asians were twice as likely to have a mean Kt/V ≥1.2 compared to Caucasians (the referent group) [odds ratio (OR) (95% CI) 2.10 (1.33, 3.32), P <0.01]. They experienced similar intermediate outcomes for vascular access, anemia management, and serum albumin compared to the majority racial group. Conclusion. These findings indicate that adult hemodialysis Asian patients experience similar or better intermediate outcomes compared to the majority racial group. Further study is needed to determine if these results are associated with improved survival and less morbidity in this minority group.

AB - Background. There is a paucity of information regarding the clinical experience of Asian hemodialysis patients. This paper describes intermediate outcomes for adult Asian hemodialysis patients compared to Caucasians and African Americans. Methods. Dialysis facility staff abstracted clinical information on a national random sample of adult hemodialysis patients from October through December 2000. Associations of race with intermediate outcomes were tested by bivariate analyses and multivariable logistic regression modeling. Results. A total of 429 patients were identified as Asian, 4403 as Caucasians, and 3103 as African Americans. Asian and Caucasian patients were older than African Americans [mean 63.2 (±15.6), 63.9 (±15.2), and 57.7 (±14.7) years, P <0.001], and had fewer years on dialysis [mean 3.5 (±3.8), 3.1 (±3.8), and 4.1 (±4.1) years, P <0.001]. Ninety three percent of Asians, 87% of Caucasians, and 84% of African Americans had a mean Kt/V ≥1.2 (P <0.001). In addition, 36% of Asians, 32% of Caucasians, and 26% of African Americans had an arteriovenous (AV) fistula as their vascular access (P <0.001). Hemoglobin profiles were only slightly different among the three racial groups. More Asians and African Americans had a mean serum albumin ≥4.0/3.7 g/dL compared to Caucasians (33% and 31% compared to 27%, respectively, P <0.001). In the final multivariable logistic regression model, Asians were twice as likely to have a mean Kt/V ≥1.2 compared to Caucasians (the referent group) [odds ratio (OR) (95% CI) 2.10 (1.33, 3.32), P <0.01]. They experienced similar intermediate outcomes for vascular access, anemia management, and serum albumin compared to the majority racial group. Conclusion. These findings indicate that adult hemodialysis Asian patients experience similar or better intermediate outcomes compared to the majority racial group. Further study is needed to determine if these results are associated with improved survival and less morbidity in this minority group.

KW - Asian

KW - Intermediate outcomes

KW - Race

UR - http://www.scopus.com/inward/record.url?scp=0037781862&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037781862&partnerID=8YFLogxK

U2 - 10.1046/j.1523-1755.2003.00121.x

DO - 10.1046/j.1523-1755.2003.00121.x

M3 - Article

C2 - 12846759

AN - SCOPUS:0037781862

VL - 64

SP - 623

EP - 631

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 2

ER -