1488-P: Closing the Racial/Ethnic Disparity Gap in Kidney Failure from Diabetes in the United States, 2000-2016

Abstract

Diabetes-related end-stage kidney disease (ESKD-D) disproportionately affects U.S. racial/ethnic minority populations compared with whites. With the recent plateau in diabetes prevalence, we assessed ESKD-D trends by race/ethnicity to determine if disparity gaps have changed. From the U.S. Renal Data System, we obtained the number of adults (whites, blacks, Hispanics, Asians, and Native Americans [NAs]) aged ≥18 years with newly treated ESKD-D (with diabetes listed as primary cause) between 2000 and 2016. ESKD-D incidence rates by race/ethnicity were calculated using Census population estimates and age-adjusted to the 2000 U.S. standard population. Average annual percentage change (AAPC) in rates was estimated using joinpoint regression. From 2000 to 2016, the age-adjusted ESKD-D rates decreased by 53% for NAs (66.7 to 31.2 per 100,000, AAPC= -4.5%, p<0.001); by 33% for Hispanics (50.0 to 33.3, AAPC= -2.1%, p<0.001); by 20% for blacks (56.2 to 44.7, AAPC= -1.6%, p=0.02), did not change for Asians, and increased by 10% for whites (15.4 to 17.0, AAPC= 0.6%, p=0.01) (Figure). ESKD-D incidence declined for NAs, Hispanics, and blacks, narrowing the gap with whites, with NAs having the largest decline. However, in 2016, ESKD-D incidence rates in NAs, Hispanics, and blacks were about 2.0-2.5 times higher than whites. Continued efforts might be considered to sustain and improve ESKD-D trends in these populations. Disclosure N. Burrows: None. Y. Zhang: None. I.A. Hora: None. M.E. Pavkov: None. G. Imperatore: None.