Gender and racial disparities in initial hemodialysis access and outcomes in incident end-stage renal disease patients
American Journal of Nephrology Jul 17, 2018
Shah S, et al. - Researchers investigated the links between gender and race on the type of vascular access [arteriovenous (AV) access vs central venous catheters (CVC), and AV fistula vs AV graft) at hemodialysis initiation in 885,699 patients with end-stage renal disease who initiated hemodialysis between January 1, 2004 and December 31, 2014, and were identified using the US Renal Data System. They also determined the impact on 1-year mortality in these subjects. To test these links, they used multivariable logistic regression models adjusted for pre-dialysis health. They observed lower odds of using AV access for females vs males for hemodialysis initiation. The likelihood of using AV access for first outpatient hemodialysis was more among blacks and Asians and less among Hispanics when compared to whites. No significant mortality difference was observed between males and females. Asians, blacks, Hispanics, and Native Americans had lower 1-year adjusted mortality, relative to whites.
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