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Recent kidney policy changes have not created racial disparities in care

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Recent policy and guideline changes related to the care of patients with kidney failure have not created racial disparities, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Marc Turenne, PhD, from Arbor Research Collaborative for Health, and his colleagues assessed the effects the End-Stage Renal Disease Prospective Payment System, or ESRD bundle, and changes made to dosing guidelines for anemia drugs had on racial disparities in the management of anemia and mineral metabolism in 7,384 kidney failure patients at 132 dialysis facilities.

The researchers observed no meaningful overall differences by race regarding the rates of change of management practices or laboratory measures from August 2010 to December 2011. For example, declines in average doses of anemia drugs and average hemoglobin levels were similar for African American patients and patients of other races. Overall trends in injectable vitamin D doses and parathyroid hormone levels, which are key indicators of mineral metabolism care, were also similar for both race groups during this time.

“These early results are encouraging, and they indicate that recent policy and regulatory changes that are intended to improve the efficiency and quality of care for patients with kidney failure have not caused disparities by race in areas of care where there have historically been racial differences,” said Turenne. “As policy-makers look for ways to make the delivery of health care services more affordable, it’s important to ensure that patients are still receiving the highest quality of care.”

Study co-authors include Elizabeth Cope, PhD, MPH, Shannon Porenta, MPH, Purna Mukhopadhyay, PhD, Douglas Fuller, MS, Jeffrey Pearson, MS, Claudia Dahlerus, PhD, MA, Brett Lantz, MA, Francesca Tentori, MD, MS, and Bruce Robinson, MD, MS, FACP.

The article, entitled “Has Dialysis Payment Reform Led to Initial Racial Disparities in Anemia and Mineral Metabolism Management?” appears online at http://jasn.asnjournals.org/