The following is a summary of “Receiving hemodialysis in Hispanic ethnic dense communities is associated with better adherence and outcomes among young patients: a retrospective analysis of the Dialysis Outcomes and Practice Patterns Study,” published in the September 2023 issue of Nephrology by April-Sanders et al.
Researchers performed a retrospective study to determine the association between community Hispanic ethnic density (HED) and mortality risk among ethnically diverse patients receiving maintenance hemodialysis.
They analyzed patients in the United States from the Dialysis Outcomes and Practice Patterns Study (DOPPS) database (2011–2015) with 4,226 individuals. DOPPS was linked to the American Community Survey database by dialysis facility zip code to obtain the percentage of Hispanic residents (% HED). One-way ANOVA and Kruskal-Wallis tests assessed the association between HED tertiles and various factors. Cox proportional hazard models were used to estimate the mortality hazard ratio (HR) and 95% CIs by tertile of HED, stratified by age and accounting for facility clustering using a sandwich estimator.
The results showed that patients in the highest HED tertile communities were younger (average age 61.4 vs. 64.4 years), more frequently non-White (62.4% vs. 22.1%), had fewer comorbidities, had longer dialysis history, and had better adherence to dialysis treatment. Fewer prescribed minutes of dialysis compared to those in the lowest tertile. Dialyzing in the highest HED tertile was associated with a lower mortality hazard (HR, 0.86; 95% CI, 0.72-1.00). This association weakened when considering individual race/ethnicity (HR, 0.92; 95% CI, 0.78–1.09). In age-stratified analyses, individuals <64 exhibited a reduced mortality hazard in the highest (vs. lowest) HED tertile (HR, 0.66; 95% CI, 0.49–0.90). No significant associations were observed among patients aged 64 and older.
They concluded Treatment in HED and integrated communities was associated with lower mortality among younger patients.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-023-03297-w
