ArticleClinical kidney journal2017
Impact of poverty and race on pre-end-stage renal disease care among dialysis patients in the United States.
Article in Clinical kidney journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Article
- Trends in Co-morbid Dementia and Chronic Kidney Disease.Journal of general internal medicine · 2025Article
- The Association between Residential Segregation and Access to Kidney Transplantation: Evidence from a Multistate Cohort Study.Clinical journal of the American Society of Nephrology : CJASN · 2024Article
- Social Determinants of Health Impacting Access to Renal Dialysis for Racial/Ethnic Minorities.Cureus · 2023Review
- Vital Signs: Health Disparities in Hemodialysis-Associated Staphylococcus aureus Bloodstream Infections - United States, 2017-2020.MMWR. Morbidity and mortality weekly report · 2023Article
- Racial/Ethnic Disparities in the Alzheimer's Disease Link with Cardio and Cerebrovascular Diseases, Based on Hawaii Medicare Data.Journal of Alzheimer's disease reports · 2023Article
- Despite National Declines In Kidney Failure Incidence, Disparities Widened Between Low- And High-Poverty US Counties.Health affairs (Project Hope) · 2021Article
- A Cascade of Structural Barriers Contributing to Racial Kidney Transplant Inequities.Advances in chronic kidney disease · 2021Review
- Impact of pre-dialysis nephrology care engagement and decision-making on provider and patient action toward permanent vascular access.BMC nephrology · 2021Article
- National Trends in the Association of Race and Ethnicity With Predialysis Nephrology Care in the United States From 2005 to 2015.JAMA network open · 2020Article
- American Indian chronic Renal insufficiency cohort study (AI-CRIC study).BMC nephrology · 2020Article
- Perspectives in Individualizing Solutions for Dialysis Access.Advances in chronic kidney disease · 2020Review
- The newClinical kidney journal · 2019Article
- Association of the kidney allocation system with dialysis exposure before deceased donor kidney transplantation by preemptive wait-listing status.Clinical transplantation · 2018Article
- The Landscape of Diabetic Kidney Disease in the United States.Current diabetes reports · 2018Review
- Gender and Racial Disparities in Initial Hemodialysis Access and Outcomes in Incident End-Stage Renal Disease Patients.American journal of nephrology · 2018Observational
- A mixed-methods investigation of incident Hemodialysis access in a safety-net population.BMC nephrology · 2017Article
- Does wealth make health? Cherchez la renal replacement therapy.Clinical kidney journal · 2017Article
- Neighborhood Socioeconomic Status and Quality of Kidney Care: Data From Electronic Health Records.Kidney medicineArticle
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccess to nephrology care prior to end-stage renal disease (ESRD) is significantly associated with lower rates of morbidity and mortality. We assessed the association of area-level and individual-level indicators of poverty and race/ethnicity on pre-ESRD care provided by nephrologists.
methodsIn this retrospective cohort study using the US Renal Data System database, we identified 739 537 patients initiated on maintenance dialysis from 1 January 2007 through 31 December 2012. We assessed the Medicare-Medicaid dual eligibility status as an indicator of individual-level poverty and ZIP code-level median household income (MHI) data obtained from the 2010 US census. We conducted multivariable logistic regression of pre-ESRD nephrology care as the outcome variable.
resultsAmong patients in the lowest area-level MHI quintile, 61.28% received pre-ESRD nephrology care versus 67.68% among those in higher quintiles (P < 0.001). Similarly, the proportions of dual-eligible and nondual-eligible patients who had pre-ESRD nephrology care were 61.49 and 69.84%, respectively (P < 0.001). Patients in the lowest area-level MHI quintile were associated with significantly lower likelihood of pre-ESRD nephrology care (adjusted odds ratio [aOR] 0.86 [95% confidence interval (CI) 0.85-0.87]) compared with those in higher quintiles. Both African American (AA) and Hispanic patients were significantly less likely to have received pre-ESRD nephrology care [aOR 0.85 (95% CI 0.84-0.86) and aOR 0.72 (95% CI 0.71-0.74), respectively].
conclusionsIndividual- and area-level measures of poverty, AA race and Hispanic ethnicity were independently associated with a lower likelihood of pre-ESRD nephrology care. Efforts to improve pre-ESRD nephrology care may require focusing on the poor and minority groups.
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