ETHNIC-DIFFERENCES IN THE USE OF PERITONEAL-DIALYSIS AS INITIAL TREATMENT FOR END-STAGE RENAL-DISEASE

Objective.-To evaluate the influence of ethnicity on the use of perito neal dialysis (PD) as initial treatment for end-stage renal disease (E SRD) after controlling for other patient characteristics. Design.-Ince ption cohort analysis of incident ESRD patients. Patients.-All African -American and white patients (N=10726) who began treatment for ESRD at dialysis centers in North Carolina, South Carolina, and Georgia and r eported to ESRD Network 6 between January 1, 1989, and December 31, 19 91.Main Outcome Measure.-Odds ratios (ORs) of the association between ethnicity and PD as initial treatment modality. Results.-African-Ameri can patients were 56% less likely than whites to use PD (OR, 0.44; 95% confidence interval [CI], 0.40 to 0.49). This difference persisted (O R, 0.45; 95% CI, 0.38 to 0.52) after multivariable adjustment for age, education, social support, home ownership, functional status, albumin level, hypertension, history of myocardial infarction, peripheral neu ropathy, and comorbid diabetes. Conclusions.-Ethnic differences in ini tial PD use cannot be explained by many demographic, socioeconomic, an d comorbid factors associated with the use of PD as initial treatment for ESRD.