Race and geography contribute to significant variations in care for patients with end-stage kidney disease, according to a study by the University of Washington Schools of Public Health and Medicine. African Americans with kidney failure were more likely than White patients to continue dialysis and less likely to be referred to hospice care, according to the study, led by Dr. Bernadette Thomas, a senior clinical research fellow. The differences were especially pronounced in those regions with the highest levels of end-of-life Medicare spending, the study found.