Emergency Department Use by Patients With End-stage Renal Disease in the United States
Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD vs. those without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits were ESRD patients. ED patients with ESRD were mostly non-Hispanic whites (51.5%) and males were more likely to be ESRD patients than females (aOR: 1.48; 95% CI: 1.47–1.48). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.22; 95% CI: 2.21–2.22) and intensive care unit (ICU) (aOR: 1.53; 95% CI: 1.52–1.54) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests, get medical imaging tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.