Ethnic Differences in the Use of Peritoneal Dialysis as Initial Treatment for End-Stage Renal Disease

Abstract

To evaluate the influence of ethnicity on the use of peritoneal dialysis (PD) as initial treatment for end-stage renal disease (ESRD) after controlling for other patient characteristics. Inception cohort analysis of incident ESRD patients. All African-American and white patients (N = 10,726) who began treatment for ESRD at dialysis centers in North Carolina, South Carolina, and Georgia and reported to ESRD Network 6 between January 1, 1989, and December 31, 1991. Odds ratios (ORs) of the association between ethnicity and PD as initial treatment modality. African-American 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 (OR, 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 neuropathy, and comorbid diabetes. Ethnic differences in initial PD use cannot be explained by many demographic, socioeconomic, and comorbid factors associated with the use of PD as initial treatment for ESRD.