Limitations:
Our study results should be interpreted in the context of following key limitations. (1) NIS is an administrative, claims based database that relies on ICD coding system. These codes can be subjected to errors, however, HCUP quality control measures are routinely instituted that mitigate such concerns (9). Additionally, the positive predictive value of ESRD codes is close to 96% (24). (2) There are no specific ICD codes for in-hospital arrest and previous studies have utilized demonstration of CPR as evidence of in-hospital arrest and we have replicated the same methodology in our current analysis. (3) NIS does not inform on detailed management of SCA and specifically no data is collected on quality of CPR and other measures that are practiced as part of advanced life support. (4) NIS censors data gathering at discharge and patients are not followed longitudinally. ESRD patients who sustained SCA have been shown to have poor survival on follow-up studies and that cannot be investigated from NIS dataset (25).