Ethnic differences in the use of peritoneal dialysis as initial treatment for end-stage renal disease.
OBJECTIVE
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.


METHODS
Inception cohort analysis of incident ESRD patients.


METHODS
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.


METHODS
Odds ratios (ORs) of the association between ethnicity and PD as initial treatment modality.


RESULTS
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.


CONCLUSIONS
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.
Barker-Cummings
C
C
Department of Epidemiology, Emory University, Atlanta, GA 30322, USA.
McClellan
W
W
Soucie
J M
JM
Krisher
J
J
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013022:South Carolina / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*