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J Am Soc Nephrol 14:180-186, 2003
© 2003 American Society of Nephrology

Survival Advantage for Adult Hispanic Hemodialysis Patients? Findings from the End-Stage Renal Disease Clinical Performance Measures Project

Diane L. Frankenfield*, Michael V. Rocco{dagger}, Sheila H. Roman* and William M. McClellan{ddagger},§

*Centers for Medicare & Medicaid Services, Center for Beneficiary Choices, Baltimore, Maryland; {dagger}Wake Forest University School of Medicine, Section on Nephrology, Winston-Salem, North Carolina; {ddagger}Georgia Medical Care Foundation, Atlanta, Georgia; §Emory University, Department of Medicine, Rollins School of Public Health, Atlanta, Georgia.

Correspondence to Dr. Diane L. Frankenfield, Centers for Medicare & Medicaid Services, Center for Beneficiary Choices, 7500 Security Boulevard, Mailstop S3-02-01, Baltimore, MD 21244. Phone: 410-786-7293; Fax: 410-786-8532;

ABSTRACT. One-year follow-up mortality in Hispanic and non-Hispanic patients and its association with intermediate outcomes of dialytic care were examined utilizing the Center for Medicare & Medicaid Services’ (CMS) ESRD Clinical Performance Measures (CPM) Project and administrative data. Demographic and clinical information was collected on a national random sample of adult in-center hemodialysis (HD) patients for the period of October through December, 1998. Patients were categorized as Hispanic, non-Hispanic White, or non-Hispanic Black. Of 8336 patients 994 (12%) were identified as Hispanic, 3618 (43%) as non-Hispanic White, and 3111 (37%) as non-Hispanic Black. The adjusted 12-mo mortality risk (99% CI) for Hispanics was 0.76 (0.60 to 0.96; P < 0.01) and for non-Hispanic Blacks 0.66 (0.56 to 0.78, P < 0.001) compared with non-Hispanic Whites (referent). Similar 12-mo mortality risks were noted in the groups with diabetes mellitus or hypertension as the causes of ESRD and among patients >=65 yr. After controlling for demographic and geographic variables, Hispanics compared with the referent group, non-Hispanic Whites, were more likely to have a mean serum albumin >=4.0/3.7 g/dL (BCG/BCP) (1.5 [1.2 to 1.7]; P < 0.001) and as likely to have a mean Kt/V >=1.2, mean hemoglobin >=11 g/dL, and an arteriovenous fistula as their vascular access. These data suggest that adult Hispanic HD patients have a 12-mo survival intermediate to non-Hispanic Blacks and non-Hispanic Whites and experience equivalent or better intermediate outcomes of dialytic care compared with non-Hispanic Whites. E-mail: dfrankenfield@cms.hhs.gov




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