Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients: Results from the 1997 ESRD core indicators project

D. L. Frankenfield, M. V. Rocco, P. R. Frederick, J. Pugh, W. M. McClellan, Jr Owen W.F.

Research output: Contribution to journalArticle

Abstract

Principal goals of the End-Stage Renal Disease (ESRD) Core Indicators Project are to improve the care provided to ESRD patients and to identify categorical variability in intermediate outcomes of dialysis care. The purpose of the current analysis is to extend our observations about the variability of intermediate outcomes of ESRD care among different racial and gender groups to a previously unreported group, Hispanic Americans. This group is a significant and growing minority segment of the ESRD population. A random sample of Medicare-eligible adult, in-center, hemodialysis patients was selected and stratified from an end-of-year ESRD patient census for 1996. Of the 6,858 patients in the final sample, 45% were non-Hispanic whites, 36% were non-Hispanic blacks, and 11% were Hispanic. Whites were older than blacks or Hispanics (P <0.001). Hispanics were more likely to have diabetes mellitus as a primary diagnosis than either blacks or whites (P <0.001). Even though they received longer hemodialysis times and were treated with high-flux hemodialyzers, blacks had significantly lower hemodialysis doses than white or Hispanic patients (P <0.001). The intradialytic weight losses were greater for blacks (P <0.05). The delivered hemodialysis dose was lower for blacks than for whites or Hispanics whether measured as a urea reduction ratio (URR) or as the Kt/V calculated by the second generation formula of Daugirdas (median 1.32, 1.36, and 1.37, respectively, P <0.001). Hispanics and whites had modestly higher hematocrits than blacks (33.2, 33.2, and 33.0%, respectively, P <0.01). There was no significant difference among groups in the weekly prescribed epoetin alfa dose (~172 units/kg/week). A significantly greater proportion of Hispanic patients had transferrin saturations ≥20% compared with the other two groups (P <0.001). Logistic regression modeling revealed that whites were significantly more likely to have serum albumin

Original languageEnglish (US)
Pages (from-to)721-730
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume34
Issue number4
StatePublished - 1999

Fingerprint

Hispanic Americans
Chronic Kidney Failure
Renal Dialysis
Epoetin Alfa
Artificial Kidneys
Censuses
Transferrin
Medicare
Hematocrit
Serum Albumin
Urea
Weight Loss
Dialysis
Diabetes Mellitus
Logistic Models
Population

Keywords

  • Demographics
  • Ethnicity
  • Health Care Financing Administration
  • Hemodialysis
  • Hispanic
  • Race

ASJC Scopus subject areas

  • Nephrology

Cite this

Frankenfield, D. L., Rocco, M. V., Frederick, P. R., Pugh, J., McClellan, W. M., & Owen W.F., J. (1999). Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients: Results from the 1997 ESRD core indicators project. American Journal of Kidney Diseases, 34(4), 721-730.

Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients : Results from the 1997 ESRD core indicators project. / Frankenfield, D. L.; Rocco, M. V.; Frederick, P. R.; Pugh, J.; McClellan, W. M.; Owen W.F., Jr.

In: American Journal of Kidney Diseases, Vol. 34, No. 4, 1999, p. 721-730.

Research output: Contribution to journalArticle

Frankenfield, DL, Rocco, MV, Frederick, PR, Pugh, J, McClellan, WM & Owen W.F., J 1999, 'Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients: Results from the 1997 ESRD core indicators project', American Journal of Kidney Diseases, vol. 34, no. 4, pp. 721-730.
Frankenfield, D. L. ; Rocco, M. V. ; Frederick, P. R. ; Pugh, J. ; McClellan, W. M. ; Owen W.F., Jr. / Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients : Results from the 1997 ESRD core indicators project. In: American Journal of Kidney Diseases. 1999 ; Vol. 34, No. 4. pp. 721-730.
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