ETHNICITY could play a role in hospitalisation outcomes for patients with advanced kidney disease, and assist decision-making, according to new research presented at the American Society of Nephrology annual conference Kidney Week 2022, held in Orlando, Florida, USA.
Researchers from the University of California, Irvine, USA, reviewed the medical records of >309,000 people with advanced kidney disease over a 13-year period, who had either been managed conservatively or treated with dialysis. Given the “growing recognition of the importance of conservative non-dialytic management as an alternative patient-centred treatment strategy for advanced kidney disease,” as stated by research team member Connie Rhee, Department of Medicine, University of California, Irvine, the authors set out to review whether ethnicity influences outcomes for those treated with dialysis versus those treated conservatively.
The team found that overall, 55% of patients experienced at least one hospital admission during this follow-up period, and that certain ethnic groups had higher hospitalisation rates when treated with dialysis compared to those who were managed conservatively. This was apparent for people with Hispanic, non-Hispanic Black, and non-Hispanic White ethnicities. Further, the team identified that patients with these ethnicities who were initiated on dialysis at an earlier point, and had higher levels of kidney function, showed the highest rates of hospitalisation.
Whilst the research also revealed that Asian ethnicity conferred a higher rate of hospitalisation if treated with dialysis, in contrast to patients with Hispanic, non-Hispanic Black, and non-Hispanic White ethnicities, patients with Asian ethnicity had higher hospitalisation rates if dialysis was commenced at a later stage with lower residual kidney function than those who were treated with dialysis at an earlier stage. This difference was particularly prominent with increasing age.
Rhee highlighted that uncertainties surrounding which patients will benefit most from dialysis versus conservative management could explain why conservative management is “under-utilised in the US”. Therefore, these findings are of clinical relevance to nephrologists because they could help doctors and patients to make more personalised, shared, and informed treatment decisions when managing advanced kidney disease.