OBJECTIVE: To describe end-stage renal disease (ESRD) quality of care (receipt of pre-ESRD nephrology care, access to kidney transplantation, and placement of permanent vascular access for dialysis) in US patients with ESRD due to lupus nephritis (LN-ESRD) and to examine whether quality measures differ by patient sociodemographic characteristics or US region. METHODS: National surveillance data on patients in the US in whom treatment for LN-ESRD was initiated between July 2005 and September 2011 (n = 6,594) were analyzed. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were determined for each quality measure, according to sociodemographic factors and US region. RESULTS: Overall, 71% of the patients received nephrology care prior to ESRD. Black and Hispanic patients were less likely than white patients to receive pre-ESRD care (OR 0.73 [95% CI 0.63-0.85] and OR 0.73 [95% CI 0.60-0.88], respectively) and to be placed on the kidney transplant waitlist within the first year after the start of ESRD (HR 0.78 [95% CI 0.68-0.91] and HR 0.82 [95% CI 0.68-0.98], respectively). Those with Medicaid (HR 0.51 [95% CI 0.44-0.58]) or no insurance (HR 0.36 [95% CI 0.29-0.44]) were less likely than those with private insurance to be placed on the waitlist. Only 24% had a permanent vascular access, and placement was even less likely among the uninsured (OR 0.62 [95% CI 0.49-0.79]). ESRD quality-of-care measures varied 2-3-fold across regions of the US, with patients in the Northeast and Northwest generally having higher probabilities of adequate care. CONCLUSION: LN-ESRD patients have suboptimal ESRD care, particularly with regard to placement of dialysis vascular access. Minority race/ethnicity and lack of private insurance are associated with inadequate ESRD care. Further studies are warranted to examine multilevel barriers to, and develop targeted interventions to improve delivery of, care among patients with LN-ESRD.
OBJECTIVE: To describe end-stage renal disease (ESRD) quality of care (receipt of pre-ESRD nephrology care, access to kidney transplantation, and placement of permanent vascular access for dialysis) in US patients with ESRD due to lupus nephritis (LN-ESRD) and to examine whether quality measures differ by patient sociodemographic characteristics or US region. METHODS: National surveillance data on patients in the US in whom treatment for LN-ESRD was initiated between July 2005 and September 2011 (n = 6,594) were analyzed. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were determined for each quality measure, according to sociodemographic factors and US region. RESULTS: Overall, 71% of the patients received nephrology care prior to ESRD. Black and Hispanic patients were less likely than white patients to receive pre-ESRD care (OR 0.73 [95% CI 0.63-0.85] and OR 0.73 [95% CI 0.60-0.88], respectively) and to be placed on the kidney transplant waitlist within the first year after the start of ESRD (HR 0.78 [95% CI 0.68-0.91] and HR 0.82 [95% CI 0.68-0.98], respectively). Those with Medicaid (HR 0.51 [95% CI 0.44-0.58]) or no insurance (HR 0.36 [95% CI 0.29-0.44]) were less likely than those with private insurance to be placed on the waitlist. Only 24% had a permanent vascular access, and placement was even less likely among the uninsured (OR 0.62 [95% CI 0.49-0.79]). ESRD quality-of-care measures varied 2-3-fold across regions of the US, with patients in the Northeast and Northwest generally having higher probabilities of adequate care. CONCLUSION:LN-ESRDpatients have suboptimal ESRD care, particularly with regard to placement of dialysis vascular access. Minority race/ethnicity and lack of private insurance are associated with inadequate ESRD care. Further studies are warranted to examine multilevel barriers to, and develop targeted interventions to improve delivery of, care among patients with LN-ESRD.
Authors: Suma Prakash; Rudolph A Rodriguez; Peter C Austin; Refik Saskin; Alicia Fernandez; Louise M Moist; Ann M O'Hare Journal: J Am Soc Nephrol Date: 2010-06-17 Impact factor: 10.121
Authors: Linda T Hiraki; Bing Lu; Steven R Alexander; Tamara Shaykevich; Graciela S Alarcón; Daniel H Solomon; Wolfgang C Winkelmayer; Karen H Costenbader Journal: Arthritis Rheum Date: 2011-07
Authors: William M McClellan; Haimanot Wasse; Ann C McClellan; James Holt; Jenna Krisher; Lance A Waller Journal: J Am Soc Nephrol Date: 2010-08-05 Impact factor: 10.121
Authors: J Bradley Layton; Susan L Hogan; Caroline E Jennette; Barbara Kenderes; Jenna Krisher; J Charles Jennette; William M McClellan Journal: Clin J Am Soc Nephrol Date: 2010-08-05 Impact factor: 8.237
Authors: Ronald L Pisoni; Eric W Young; Dawn M Dykstra; Roger N Greenwood; Erwin Hecking; Brenda Gillespie; Robert A Wolfe; David A Goodkin; Philip J Held Journal: Kidney Int Date: 2002-01 Impact factor: 10.612
Authors: Rachel E Patzer; Sandra Amaral; Haimanot Wasse; Nataliya Volkova; David Kleinbaum; William M McClellan Journal: J Am Soc Nephrol Date: 2009-04-01 Impact factor: 10.121
Authors: R W Evans; D L Manninen; L P Garrison; L G Hart; C R Blagg; R A Gutman; A R Hull; E G Lowrie Journal: N Engl J Med Date: 1985-02-28 Impact factor: 91.245
Authors: Vanessa Grubbs; Laura C Plantinga; Eric Vittinghoff; Ann M O'Hare; R Adams Dudley Journal: BMC Health Serv Res Date: 2012-08-16 Impact factor: 2.655
Authors: Tamar B Rubinstein; Wenzhu B Mowrey; Norman T Ilowite; Dawn M Wahezi Journal: Arthritis Care Res (Hoboken) Date: 2018-02-07 Impact factor: 4.794
Authors: Sidha Sreedharan; Ning Li; Geoff Littlejohn; Russell Buchanan; Mandana Nikpour; Eric Morand; Alberta Hoi; Vera Golder Journal: Arthritis Res Ther Date: 2022-06-22 Impact factor: 5.606
Authors: Laura C Plantinga; Rachel E Patzer; Cristina Drenkard; Stephen O Pastan; Jason Cobb; William McClellan; Sung Sam Lim Journal: BMC Nephrol Date: 2015-03-29 Impact factor: 2.388
Authors: Katherine P Pryor; Medha Barbhaiya; Karen H Costenbader; Candace H Feldman Journal: Rheum Dis Clin North Am Date: 2020-10-29 Impact factor: 2.670