Intermediate outcomes by race and ethnicity in peritoneal dialysis patients: Results from the 1997 ESRD Core Indicators project

Background: Hispanics are the fastest growing minority group in the United States, and approximately 10% of all end-stage renal disease (ESRD) patient s are Hispanic. Few data are available, however, regarding dialysis adequac y and anemia management in Hispanic patients receiving peritoneal dialysis in the U.S. Methods: Data from the Health Care Financing Administration (HCFA) ESRD Cor e Indicators Project were used to assess racial and ethnic differences in s elected intermediate outcomes for peritoneal dialysis patients. Results: Of the 1219 patients for whom data were available from the 1997 sa mple, 9% were Hispanic, 24% were non-Hispanic blacks, and 59% were non-Hisp anic whites. Hispanics were more likely to have diabetes mellitus as a caus e of ESRD compared to blacks or whites, and both Hispanics and blacks were younger than white patients (both p < 0.001). Although whites had higher we ekly Kt/V and creatinine clearance values compared to blacks or Hispanics ( p < 0.05), blacks had been dialyzing longer (p < 0.01) and were more likely to be anuric compared to the other two groups (p < 0.001). Blacks had sign ificantly lower mean hematocrit values (p < 0.001) and a greater proportion of patients who had a hematocrit level less than 28% (p < 0.05) compared t o Hispanics or whites, despite receiving significantly larger weekly mean e poetin alfa doses (p < 0.05) and having significantly higher mean serum fer ritin concentrations (p < 0.01). Multivariate logistic regression analysis revealed significant differences by race/ethnicity for experiencing a weekl y Kt/V urea < 2.0 and hypertension, but not for other intermediate outcomes examined (weekly creatinine clearance < 60 L/week/1.73 m(2), Hct < 30%, an d serum albumin < 3.5/3.2 g/dL). Conclusion: Hispanics had adequacy values similar to blacks and anemia para meters similar to whites. Additional studies are needed to determine the et iologies of the differences in intermediate outcomes by racial and ethnic g roupings in peritoneal dialysis patients.