Dialysis and Death for Native Americans

Dialysis care and mortality among Native Americans differs by region

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A variety of factors - such as diabetes, obesity, heart disease, and ethnicity - can affect a person's risk of death from kidney failure. For Native Americans, geography may play a role in kidney failure risk.

The proportion of dialysis centers treating American Indians/Alaska Natives differs depending on the geographic region of the United States. These regional differences may account for the varied death rates of American Indians/Alaska Natives across the United States.

"Better access to dialysis facilities could improve kidney patients care."

American Indians/Alaska Natives make up a group of people from diverse backgrounds. Many Native American communities have high rates of end-stage renal disease, or the near or complete failure of kidney function. Yoshio N. Hall, M.D., of the University of Washington, and colleagues wanted to study the regional features of dialysis care and death rates in this population.

They found that Native Americans from the Southwest and Alaska received their dialysis care from relatively few dialysis centers. In comparison, Native Americans from the Eastern United States and the Pacific Coast received treatment from a greater number of dialysis centers.

Even though Southwest Native Americans had relatively high rates of poverty, diabetes, and heart disease (all risk factors for death from kidney failure), their death rate (13.9 percent) were lower than those from the Southern Plains (23.2 percent), Alaska (21.2 percent), Eastern United States (20.0 percent), Northern Plains (20.8 percent), and Pacific Coast (22.0 percent).

In other words, Native Americans in the Southwestern United States have access to the highest concentration of dialysis care while also experiencing the lowest death rates from kidney failure.

The authors conclude that there are regional differences in the structure of dialysis care and risk of death among American Indians/Alaska Natives. Their results suggest that future studies looking at the structure of dialysis care across different areas may be able to explain what causes these regional differences. Understanding the regional differences may help experts and policymakers improve the quality of care for many Native American communities.

The study is published in the Journal of the American Society of Nephrology.

Reviewed by: 
Review Date: 
December 15, 2011
Last Updated:
December 16, 2011