scholarly journals The association between prevalence of peritoneal dialysis vs hemodialysis and patients' distance to dialysis-providing facilities

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0004762021
Author(s):  
Pattharawin Pattharanitima ◽  
Osama El Shamy ◽  
Kinsuk Chauhan ◽  
Aparna Saha ◽  
Huei Hsun Wen ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Dialysis Modality ◽  
End Stage Kidney Disease ◽  
Distance Analysis ◽  
Straight Line ◽  
Straight Line Distance ◽  
Dialysis Facilities ◽  
End Stage

Background: Accessibility to dialysis facilities plays a central role when deciding on a patient's long-term dialysis modality. Studies investigating the effect of distance to nearest dialysis-providing unit on modality choice have yielded conflicting results. We set out to investigate the association between patients' dialysis modality and both the driving and straight-line distances to the closest HD- and PD-providing units. Methods: All end stage kidney disease patients who initiated in-center HD and PD in 2017, 18-90 years old, and on dialysis for ≥30 days were included. Patients in residence zip codes in non-conterminous United States or lived >90 miles from the nearest HD-providing unit were excluded. Results: 102,247 patients in the United States initiated in-center HD and PD in 2017. Compared to HD patients, PD patients had longer driving distances to their nearest PD unit (4.4 vs 3.4 miles; p <0.001). Patients who lived >30 miles from the nearest HD unit were more likely to be on PD if the nearest PD unit was a distance equal to/less than the HD unit. PD utilization increased with increasing distance from patients' homes to the nearest HD unit. No change in this association was found regardless of if the PD unit was farther/closer than the nearest HD unit. This association was not seen with straight line distance analysis. Conclusions: With increasing distances from the nearest dialysis providing units (HD or PD), PD utilization increased. Using driving distance rather than straight line distance affects data analysis and outcomes. Increasing the number of PD units may have a limited impact on increasing PD utilization.

scholarly journals End-Stage Kidney Disease From Scleroderma in the United States, 1996 to 2012

2018 ◽  
Vol 3 (1) ◽  
pp. 148-154 ◽  
Author(s):  
Donal J. Sexton ◽  
Scott Reule ◽  
Robert N. Foley
Keyword(s):  
United States ◽  
Kidney Disease ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States

Circulation ◽  
2018 ◽  
Vol 138 (15) ◽  
pp. 1519-1529 ◽  
Author(s):  
Konstantinos C. Siontis ◽  
Xiaosong Zhang ◽  
Ashley Eckard ◽  
Nicole Bhave ◽  
Douglas E. Schaubel ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Kidney Disease ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Contraceptive Use Among Women With End-Stage Kidney Disease on Dialysis in the United States

2020 ◽  
Vol 2 (6) ◽  
pp. 707-715.e1
Author(s):  
Silvi Shah ◽  
Annette L. Christianson ◽  
Charuhas V. Thakar ◽  
Samantha Kramer ◽  
Karthikeyan Meganathan ◽  
...  
Keyword(s):  
United States ◽  
Kidney Disease ◽  
Contraceptive Use ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

Trends in Place of Death for Individuals With Deaths Attributed to Advanced Chronic or End-Stage Kidney Disease in the United States

2021 ◽  
Vol 61 (1) ◽  
pp. 112-120.e1
Author(s):  
Sarah H. Cross ◽  
Joshua R. Lakin ◽  
Mallika Mendu ◽  
Ernest I. Mandel ◽  
Haider J. Warraich
Keyword(s):  
United States ◽  
Kidney Disease ◽  
The United States ◽  
Place Of Death ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Response by Siontis et al to Letter Regarding Article, “Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States”

Circulation ◽  
2019 ◽  
Vol 139 (12) ◽  
pp. 1563-1564
Author(s):  
Konstantinos C. Siontis ◽  
Xiaosong Zhang ◽  
Douglas E. Schaubel ◽  
Xiaoxi Yao ◽  
Peter A. Noseworthy ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Kidney Disease ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

Gender differences in peritoneal dialysis initiation in the US end-stage renal disease population

2020 ◽  
Vol 40 (1) ◽  
pp. 57-61
Author(s):  
Savannah L Vogel ◽  
Tripti Singh ◽  
Brad C Astor ◽  
Sana Waheed
Keyword(s):  
United States ◽  
Gender Differences ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Mean Value ◽  
Dialysis Modality ◽  
Stage Renal Disease ◽  
End Stage

Background: Overall, a disproportionately small number of end-stage renal disease (ESRD) patients start peritoneal dialysis (PD) in the United States compared to hemodialysis. Little is known about whether gender has an effect on the initial modality of renal replacement therapy utilized by patients; however, prior studies have demonstrated gender disparities in the diagnosis and treatment of various other health conditions, including kidney disease. Methods: Using data from the United States Renal Data System (USRDS), we estimated the proportion of patients utilizing PD as their initial dialysis modality between 2000 and 2014, adjusting estimates to the mean value of all covariates and compared these estimates for women and men. Results: We found that 7.9% of women and 7.5% of men used PD as their initial dialysis modality. The unadjusted odds ratio (OR) of women initiating PD as their initial modality compared to men was 1.04 (95% CI 1.02–1.05, p < 0.001). After adjustment for age, race, ethnicity, cause of ESRD, number of comorbidities, income, employment status, and timing of referral to nephrology, the difference was even more significant, with women being 12% (OR 1.12, CI 1.10–1.14, p < 0.001) more likely to initiate PD than men. However, within different subgroups, older women and women with higher number of comorbidities were less likely to be on PD than their male counterparts. Conclusions: Our results indicate that gender plays a role in the initial dialysis modality used by patients and providers should be cognizant of these gender differences. Further studies are needed to ascertain the cause of this observed difference.

scholarly journals Initial home dialysis is increased for rural patients by accessing urban facilities

Kidney360 ◽  
2022 ◽  
pp. 10.34067/KID.0006932021
Author(s):  
Joel T. Adler ◽  
S. Ali Husain ◽  
Lingwei Xiang ◽  
James R. Rodrigue ◽  
Sushrut S. Waikar
Keyword(s):  
United States ◽  
The United States ◽  
Home Dialysis ◽  
Home Location ◽  
Risk Of Mortality ◽  
Dialysis Facilities ◽  
End Stage ◽  
Rural Patients ◽  
Kidney Health

Background: The 240,000 rural patients with end stage kidney disease in the United States have less access to nephrology care and higher mortality than those in urban settings. The Advancing American Kidney Health initiative aims to increase the use of home renal replacement therapy. Little is known about how rural patients access home dialysis and the availability and quality of rural dialysis facilities. Methods: Incident dialysis patients in 2017 and their facilities were identified in the United States Renal Data System. Facility quality and service availability was analyzed with descriptive statistics. We assessed the availability of home dialysis methods depending on rural versus urban counties, and then we used multivariate logistic regression to identify the likelihood of rural patients with home dialysis as their initial modality and the likelihood of rural patients changing to home dialysis within 90 days. Finally, we assessed mortality after dialysis initiation based on patient home location. Results: Of the 97,930 dialysis initiates, 15,310 (15.6%) were rural. Rural dialysis facilities were less likely to offer home dialysis (51.4% vs 54.1%, P<0.001). While a greater proportion of rural patients (9.2 vs 8.2%, P<0.001) were on home dialysis, this was achieved by traveling to urban facilities to obtain home dialysis (OR 2.74, P<0.001). After adjusting for patient and facility factors, rural patients had a higher risk of mortality (HR 1.06, P=0.004). Conclusions: Despite having fewer facilities that offer home dialysis, rural patients were more often on home dialysis methods because they traveled to urban facilities, representing an access gap. Even if rural patients accessed home dialysis at urban facilities, rural patients still suffered worse mortality. Future dialysis policy should address this access gap to improve care and overall mortality for rural patients.

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