Table 3.

Average effects of race and ethnicity and calendar period on the odds of an initial hospital admission for an adverse renal outcome

Fixed effects	Unadjusted	Demographics & severitya	Fully adjustedb	Sensitivity Analysisc
Random effects	None	None	Hospital-level	Hospital-level
	OR [95% CI]
First hospital admission with a composite adverse renal outcome
Race and ethnicity
Non-Hispanic White	(reference)
Asian	1.56 [1.10-2.21] *	1.53 [1.05-2.21] *	1.49 [0.94-2.35]	1.55 [0.99-2.44]
Black	1.44 [1.14-1.82] **	1.37 [1.06-1.76] *	1.39 [1.08-1.79] *	1.43 [1.11-1.84] **
Hispanic Other	1.12 [0.83-1.52]	1.27 [0.92-1.77]	1.35 [0.93-1.94]	1.33 [0.91-1.94]
Hispanic White	1.18 [0.90-1.56]	1.07 [0.79-1.46]	1.18 [0.89-1.55]	1.18 [0.90-1.55]
Non-Hispanic Other	1.33 [0.96-1.84]	1.36 [0.96-1.93]	1.40 [0.97-2.04]	1.43 [0.97-2.11]
Calendar period
2006-2010	(reference)
2011-2015	0.83 [0.69-0.99] *	0.60 [0.49-0.73] ***	0.58 [0.47-0.73] ***	0.59 [0.47-0.74] ***
2016-2019	0.76 [0.62-0.92] **	0.46 [0.37-0.57] ***	0.46 [0.36-0.58] ***	0.45 [0.36-0.58] ***
First hospital admission with an ESRD diagnosis
Race and ethnicity
Non-Hispanic White	(reference)
Asian	1.41 [0.89-2.21]	1.35 [0.84-2.17]	1.27 [0.76-2.14]	1.30 [0.78-2.17]
Black	1.77 [1.33-2.36] ***	1.59 [1.17-2.16] **	1.57 [1.16-2.12] **	1.57 [1.15-2.13] **
Hispanic Other	1.38 [0.96-1.99]	1.41 [0.95-2.09]	1.43 [0.94-2.16]	1.41 [0.91-2.18]
Hispanic White	1.55 [1.11-2.16]*	1.29 [0.90-1.85]	1.38 [0.91-2.08]	1.37 [0.92-2.03]
Non-Hispanic Other	1.29 [0.84-1.96]	1.29 [0.83-2.00]	1.31 [0.76-2.25]	1.31 [0.76-2.24]
Calendar period
2006-2010	(reference)
2011-2015	0.86 [0.69-1.06]	0.67 [0.54-0.85] **	0.66 [0.49-0.90] **	0.66 [0.49-0.90] **
2016-2019	0.81 [0.65-1.02]	0.55 [0.43-0.70] ***	0.55 [0.42-0.72] ***	0.56 [0.44-0.73] ***
First hospital admission with a dialysis procedure code
Race and ethnicity
Non-Hispanic White	(reference)
Asian	1.83 [1.27-2.65] **	1.73 [1.17-2.58] **	1.66 [1.07-2.59] *	1.73 [1.10-2.71] *
Black	1.56 [1.20-2.01] **	1.50 [1.14-1.98] **	1.53 [1.14-2.05] **	1.58 [1.17-2.13] **
Hispanic Other	1.18 [0.84-1.65]	1.33 [0.92-1.92]	1.44 [0.96-2.17]	1.44 [0.94-2.19]
Hispanic White	1.30 [0.96-1.76]	1.20 [0.86-1.69]	1.31 [0.94-1.83]	1.31 [0.93-1.83]
Non-Hispanic Other	1.37 [0.96-1.97]	1.42 [0.97-2.08]	1.47 [1.01-2.13] *	1.50 [1.02-2.21] *
Calendar period
2006-2010	(reference)
2011-2015	0.85 [0.70-1.03]	0.60 [0.49-0.74] ***	0.58 [0.45-0.75] ***	0.58 [0.45-0.74] ***
2016-2019	0.70 [0.57-0.87] **	0.42 [0.33-0.53] ***	0.41 [0.31-0.55] ***	0.39 [0.30-0.53] ***

Separate unadjusted and adjusted mixed effects logistic regression models of the odds of a first PHIS hospital admission with a: I) composite renal outcome, II) ESRD diagnosis, or III) dialysis, excluding all subsequent admissions. N = 18008 for fully adjusted model of the composite renal outcome.

^*p<0.05;

^**p<0.01;

^***p<0.001

^a)Adjusted for age, census region, insurance type, median household income, APR-DRG illness severity, and seizure diagnosis. Patient sex, urban hospital, hospital volume, stroke, and CAMHD-CS mental health disorder classifications were tested in the model and did not meet criteria for retention.

^b)Adjusted for all variables in a) as fixed effects, and hospital-level clustering as a random effect.

^c)Fully adjusted model with hospital-level random effects in b), excluding patients whose index admission occurred in 2019 (N=17204 for composite outcome)