Table 1.

Characteristics of American Indians and Alaska Natives initiating dialysis 1995–2008 by geographic region

Individual-Level CharacteristicsGeographic Region
Southern PlainsAlaskaSouthwestNorthern PlainsEastern USPacific CoastP-value*
(n = 2,388)(n = 139)(n = 4,800)(n = 2,830)(n = 1,418)(n = 2,142)
Age, mean (SD), years57.9 (0.3)58.8 (1.4)56.9 (0.2)57.1 (0.3)58.3 (0.4)58.7 (0.3)<0.001
Age category, yrs, N (%)<0.001
    18–39227 (10)17 (12)498 (10)291 (10)126 (9)214 (10)
    40–49372 (16)23 (17)832 (17)472 (17)226 (16)297 (14)
    50–59655 (27)25 (18)1.348 (28)793 (28)377 (27)580 (27)
    60–69677 (28)34 (25)1.268 (26)761 (27)389 (27)546 (26)
    ≥70457 (19)40 (29)854 (18)513 (18)300 (21)505 (24)
Female, N (%)1,222 (51)68 (49)2,618 (55)1,530 (54)778 (55)1,085 (51)0.006
Health insurance, N (%)
    employer group323 (14)20 (14)617 (13)381 (14)224 (16)439 (21)
    Medicare1,078 (45)64 (46)2,017 (42)1,247 (44)529 (37)1,001 (47)
    Medicaid727 (30)50 (36)2,020 (42)1,116 (39)579 (41)650 (30)
    no coverage355 (15)4 (3)246 (5)195 (7)61 (4)228 (11)
    other coverage631 (26)77 (55)1,797 (37)1,060 (38)508 (36)534 (25)
Attributed cause of ESRD, N (%)<0.001
    diabetes1,796 (75)48 (35)3,850 (80)2,140 (76)954 (67)1,273 (59)
    hypertension262 (11)19 (14)229 (5)180 (6)169 (12)418 (19)
    glomerulonephritis117 (5)30 (22)402 (8)211 (8)123 (9)172 (8)
    cystic disease31 (1)6 (4)12 (0)28 (1)13 (1)24 (1)
    other182 (8)36 (26)307 (6)271 (10)159 (11)255 (12)
Clinical and laboratory measures, N (%)
    diabetes1,734 (73)61 (44)3,767 (79)2,166 (76)996 (70)1,289 (60)<0.001
    CVD§966 (40)49 (35)1,389 (29)1,211 (43)479 (34)815 (38)<0.001
    poor functional status197 (8)13 (9)211 (4)199 (7)91 (6)110 (5)<0.001
    drug or tobacco use176 (7)23 (17)101 (2)277 (10)120 (8)166 (8)<0.001
    cancer103 (4)9 (6)84 (2)111 (4)56 (4)83 (4)<0.001
    BMI** >30 kg/m2704 (31)39 (37)1,426 (30)984 (37)488 (40)680 (34)<0.001
    serum albumin <3.5 g/dl1,416 (74)77 (58)2,644 (83)1,923 (82)824 (77)1,186 (71)<0.001
    hemoglobin <10 g/dl1,403 (63)72 (55)1,818 (53)1,550 (58)711 (55)1,162 (58)<0.001
    ESA††460 (19)59 (43)925 (19)992 (35)480 (34)661 (31)<0.001
ZIP code-level characteristic
Residents living in poverty, N (%)<0.001
    <5%52 (2)4 (4)81 (2)106 (4)58 (4)182 (9)
    5–9%221 (10)47 (46)249 (5)450 (16)239 (18)379 (18)
    10–14%412 (18)41 (41)362 (8)372 (14)356 (27)315 (15)
    15–19%694 (31)2 (2)480 (10)342 (12)247 (18)302 (15)
    ≥20%862 (38)7 (7)3,403 (74)1,473 (54)437 (33)891 (43)
Mean per capita income, $ (SD)15,103 (84)21,720 (458)10,918 (83)13,339 (113)17,826 (201)17,631 (147)<0.001
Percentage of adults with 4-yr college degree, % (SD)
15 (8)23 (8)11 (9)16 (9)18 (12)18 (12)<0.001
  • *P-value for the global F-test statistic <0.001 (test of homogeneity).

  • †Due to rounding percentages may not total 100%;

  • ‡Health insurance coverage may sum to greater than 100% in patients with multiple sources of coverage;

  • §Cardiovascular disease;

  • **Body mass index;

  • ††Prescribed erythropoiesis-stimulating agent; SD = standard deviation.

  • Data are presented without imputation and reflect values at the time of initiation of renal replacement therapy; Overall, 24.9% of study subjects were missing data for serum albumin, 14.7% for hemoglobin, 5.3% for body mass index, 4.7% for residential poverty, and 1.2% for zipcode.