Effect of race on access to recombinant human erythropoietin in long-term hemodialysis patients

JAMA. 1994 Jun 8;271(22):1760-3.


Objective: To quantify access to recombinant human erythropoietin (EPO) among patients with dialysis-dependent end-stage renal disease (ESRD).

Design: National random sample of hemodialysis patients from a random sample of dialysis units, using data abstracted from patients' medical records.

Setting: All US hemodialysis units.

Participants: A total of 4024 Medicare-entitled in-center hemodialysis patients.

Main outcome measures: The relative odds that black patients received EPO (compared with white patients).

Results: There was no evidence in this national study that black hemodialysis patients were more or less likely to receive EPO than white patients (P = .74).

Conclusions: Three years after Food and Drug Administration approval and Medicare coverage of EPO, there was no evidence of racial disparity in access to EPO among Medicare patients with ESRD who were receiving long-term hemodialysis. However, there was evidence of greater need for EPO among black patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Continental Ancestry Group*
  • Erythropoietin / therapeutic use*
  • European Continental Ancestry Group
  • Health Services Accessibility / statistics & numerical data*
  • Hematocrit / statistics & numerical data
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / therapy*
  • Logistic Models
  • Odds Ratio
  • Recombinant Proteins / therapeutic use
  • Renal Dialysis / statistics & numerical data*


  • Recombinant Proteins
  • Erythropoietin