Race-and Ethnicity-Related Disparities in Predialysis Nephrology Care, Kidney Disease Education, and Home Dialysis Utilization

What is it about?

Across the timeline of kidney disease, upstream disparities can influence and promote downstream disadvantages and negatively influence clinical outcomes. We examined the extent to which disparities in pre-dialysis clinical care, as reflected by kidney doctor care and dialysis-targeted education, influence home dialysis underuse among marginalized populations. We found that advanced kidney disease care disparities lead to about 30% home dialysis underuse among Hispanic individuals and 14% underuse among Black individuals at the start of the dialysis. We also found that these influences persist long after dialysis initiations. Finally, we also found that these clinical cares likely interact with a complex ecosystem of other barriers, necessitating more complex future studies. Overall, these findings provide a strong rationale for addressing care disparities early in the course of disease to benefit more severe and advanced stage complications.

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