Predialysis Nephrology Care Disparities and Incident Vascular Access Among Hispanic Individuals

Are disparities in predialysis care associated with having a mature, usable vascular access at dialysis initiation among Hispanic individuals?In this cohort study of 427 340 eligible patients using data from the US Renal Data System, Hispanic individuals had 23% lower rates of mature usable vascular access at dialysis initiation vs White individuals, despite being younger and having less comorbidity burden. Approximately one-third (32.59%) of these differences were attributable to a lack of access to nephrology care before dialysis.These findings suggest that targeted system-based remedies and policies are required to improve timely identification and nephrology referrals among Hispanic individuals to achieve equitable improvements in incident kidney failure outcomes.

Corresponding Author: Ashutosh M. Shukla, MBBS, MD, Division of Nephrology, Hypertension and Transplantation, North Florida/South Georgia VHS and University of Florida, 1600 Archer Rd, Gainesville, FL 32610 (ashushukla@hotmail.com).

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