Abstract: TH-PO848
Who Receives Kidney Disease Education? An Analysis of Patients with ESKD
Session Information
- Race, Ethnicity, and Gender in Kidney Health and Care
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Preblick, Ron, Genzyme Corporation, Cambridge, Massachusetts, United States
- Potukuchi, Praveen Kumar, Genzyme Corporation, Cambridge, Massachusetts, United States
- Voss, Jessica, Genzyme Corporation, Cambridge, Massachusetts, United States
- Gutierrez, Cynthia, Genesis Research LLC, Hoboken, New Jersey, United States
- Acquaviva, Danielle, Genesis Research LLC, Hoboken, New Jersey, United States
- Kelkar, Mona, Genesis Research LLC, Hoboken, New Jersey, United States
- Hong, Yu, Genesis Research LLC, Hoboken, New Jersey, United States
- Waterman, Amy D., Houston Methodist Hospital, Houston, Texas, United States
Background
While kidney disease education (KDE) is linked to improved outcomes for ESRD patients, disparities in uptake exist. We evaluated the association of KDE with social determinants of health (SDOH) among 519,902 patients with ESRD.
Methods
This retrospective cohort study was conducted using data from Medicare-linked US Renal Data System (USRDS), the Agency for Healthcare Research and Quality (AHRQ) SDOH database, and the Robert Graham Center's calculated social deprivation index (SDI). Included patients had a CMS2728 fill date between Jun 30, 2011 and Sept 30, 2019, an ESRD diagnosis ±30 days of the fill date, and ≥1-year pre-index activity. KDE status was assessed in the 2-year pre-index period. Baseline characteristics were assessed using CMS2728 and Medicare claims. Neighborhood variables were linked at the zip code level. Post-index ESRD treatments were assessed during a variable follow-up period. Univariate logistic regression was used to test SDOH differences between KDE and non-KDE patients.
Results
Of the patients identified, 7,838 received KDE (1.5%). Most received individual KDE (75.6% vs group [23.1%] or both [1.3%]), with mean of 1.6 sessions (SD 1.2). Most received KDE in stage 4 (85.6%), followed by stages 5 (13.1%) and 3 (1.3%). Black patients were less likely to receive KDE (Odds Ratio [OR] 0.92 vs White patients [95% confidence interval 0.87-0.97]), as were Hispanic patients (OR 0.72 vs non-Hispanics [0.67-0.79]). Patients who were in the most vulnerable quartile of the SDI were less likely to receive KDE than those in higher quartiles (OR 0.68; 95% CI, 0.64-0.79). Similar results were seen across SDOH factors (Figure). Throughout the post-index period, patients in the KDE group were more likely than non-KDE patients to receive peritoneal dialysis (28.1% vs 17.3%) and/or kidney transplants (4.4% vs 2.4%).
Conclusion
Identifying factors associated with KDE disparities may provide opportunities to increase utilization and improve outcomes.
Funding
- Commercial Support – Sanofi