Home dialysis data

Analysis of home dialysis provision by ethnicity in 2021. Analysis of patients on home dialysis by ethnicity shows a very similar pattern of inequality as that for 2020. The home therapy rate was 19% for White patients, 14% for Black patients, 16% for Asian patients. Amongst Asian patients there was a large difference in Home HD (1.9% compared to 6% in white patients) and a smaller difference in PD rates (14% and 13% in Asian and White patients respectively).

Amongst Black patients there is a difference in both types of home therapy (3.8% for home HD, 10% for PD).

Most centres have a small number of ethnic minority patients, so centre variation is difficult to look at. However, when the data from these centres is analysed, the difference in home therapy rates that is seen at a national level persists.

There were 11 centres which had more than 100 Asian patients on dialysis in 2021, and these centres are the same as in 2020. The data from these centres shows a slight reduction in the number of Asian patients at 14% - down from 16.3% in 2020, compared to 21% of white patients. Again, as in 2020, the highest proportion of Asian patients on home dialysis was at the Royal Free Hospital in London at 25% - a slight reduction on the 28% reported in 2020. The lowest was Leeds at 7% - last year’s lowest, Bradford had improved from 5.8% to 8%.

There were 9 centres which had more than 100 Black patients on Home Dialysis which are unchanged from last year. The data shows a drop in the figures in that 13% of these patients were on home dialysis compared to 22% of White patients as against 14% and 20.1% respectively in 2020. The highest percentage of black patients on home dialysis was at the Royal Free Hospital in London at 25% and the lowest was St Georges Hospital London at 12% These results show that for centres which had higher numbers of Asian or Black patients, the disparity in home therapy rates between minority groups and White patients was bigger than we see in England and Wales overall.

INCREASING HOME DIALYSIS IN THE CONTEXT OF COVID-19 IN THE UK – TWO YEARS ON

Table 1 - Home therapies by ethnicity and nation, prevalent patients at 31st December 2021.

Data from Scotland have been excluded due to missing data, and from N Ireland due to small numbers. Data from Exeter were not available for 2021

Table 1: Rates of home therapies amongst dialysis patients were higher in White patients (19%) than in Black patients (14%) or Asian patients(16%).

Amongst Asian patients, there was a large difference in Home HD (1.9% compared to 6.0% in White patients), and a smaller difference in PD rates (14% and 13% in Asian and White patients respectively). Amongst Black patients there is a difference in both types of home therapy (3.8% for Home HD, 10% for PD).

Results are very similar to 2020.

Tables 2 and 3: Most centres have a small number of ethnic minority patients, so centre variation is difficult to look at. When we look at centres with at least 100 Asian/Black patients, the difference in home therapy rates that is seen at a national level persists (see table below).

Table 2 - Home therapies by ethnicity for centres with >100 Asian dialysis patients

Table 3 - Home therapies by ethnicity for centres with >100 Black dialysis patients

Peritoneal Dialysis (PD), Home Haemodialysis (HHD) and total home therapies (HT = PD + HHD) by centre and deprivation quintile for patients prevalent to dialysis at the end of 2021

Table 1: The percentage of patients on HT by deprivation quintile

Rates of home therapies were lower for patients from more deprived areas, with a very similar spread to 2020. When we shared data with you previously we did not have deprivation data for Scotland. We now have this, and have included them this year, and recalculated the 2020 summary figures in Table 1 including Scotland.

Differences were seen in both HHD and PD. In 2021, only 9 centres achieved a HT rate of 20% for patients from the most deprived areas (quintile 1), compared to 34 centres for patients from the least deprived areas.