Although the incidence of end-stage kidney disease is 34% higher in US Hispanics than non-
Hispanics, the latter have a lower mortality rate following initiation of dialysis (107 vs 206 per
1,000 patient-years). 1, 2 Outcomes have not been examined in Puerto Rico, a US territory
where 4 million Hispanic Americans reside. Puerto Rico outperforms the US states and the
District of Columbia (“states” hereafter) on some measures of coverage and access, 3 but
substantial problems with quality of care have been documented. 4 Compared with …