{"doi":"10.34067/kid.0005712022","title":"Sex and Racial/Ethnic Differences in Home Hemodialysis Mortality","abstract":"Key Points Women on home hemodialysis have higher 1-year mortality than men, and women and men have comparable survival on long-term follow-up. Compared with White patients on home hemodialysis, there was no difference in all-cause mortality for Black patients, Hispanics, or Native Americans. Among patients undergoing home hemodialysis, Asians had a lower risk of all-cause mortality than White patients. Background Women and minorities constitute substantial portions of the prevalent population of patients with kidney failure. Little is known about sex and racial/ethnic differences in mortality among patients with kidney failure on home hemodialysis in the United States. Methods Using the United States Renal Data System, we retrospectively evaluated a cohort of 42,849 patients who started home hemodialysis between January 1, 2005, and December 31, 2015. We examined the association of sex and race/ethnicity with the outcome of all-cause mortality using adjusted Cox proportional hazard models and logistic regression models. Results In the study cohort, 40.4% were women, and 57.4% were White. Women on home hemodialysis had higher unadjusted death rates (26.9 versus 22.4 per 100 person-years) compared with men. There was no difference in adjusted all-cause mortality between men and women, but women had an 8% higher adjusted risk of all-cause mortality at 1 year after initiating home hemodialysis (odds ratio 1.08, 95% confidence interval [CI], 1.01 to 1.15). Regarding race/ethnicity, Hispanic, White, and Black patients had higher unadjusted death rates compared with Asians and Native Americans (25.1 versus 24.8 versus 23.2 versus 17.4 versus 16.6 per 100 person-years). There was no difference in adjusted all-cause mortality in Black, Hispanic, and Native Americans compared with White patients, while Asians had a lower risk of all-cause mortality than did White patients (hazard ratio, 0.81; 95% CI, 0.72 to 0.92). There was no difference in adjusted 1-year mortality for Asian, Black, Hispanic, and Native American patients compared with White patients. Conclusions Among patients undergoing home hemodialysis, women have higher 1-year mortality than men, and women and men have comparable survival on long-term follow-up after adjusting for other covariates. Compared with White patients, there was no difference in adjusted survival on long-term follow-up for Black patients, Hispanics, or Native Americans, while Asians had better survival. Our results suggest the need for population-wide strategies to overcome differences in home hemodialysis care.","journal":"Kidney360","year":2022,"id":279522,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":514474,"name":"Nupur Gupta","orcid":"0000-0003-2685-7304","position":1,"is_corresponding":false},{"id":305461,"name":"Annette Christianson","orcid":"0000-0002-3967-1077","position":2,"is_corresponding":false},{"id":306626,"name":"Karthikeyan Meganathan","orcid":null,"position":3,"is_corresponding":false},{"id":305460,"name":"Anthony C. Leonard","orcid":"0000-0003-2193-8084","position":4,"is_corresponding":false},{"id":305462,"name":"Charuhas V. Thakar","orcid":"0000-0003-3921-5108","position":5,"is_corresponding":false},{"id":305459,"name":"Silvi Shah","orcid":"0000-0002-9941-9404","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T00:28:55.546964Z","pmid":"36821612","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}