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Today's Date: May 31, 2023
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Not Everyone Treated Equal With Kidney Transplant
WASHINGTON — Not all racial and ethnic groups have equal
access to kidney transplantation, according to a study appearing in an upcoming issue
of the Journal of the American Society Nephrology (JASN). The results indicate that the
reasons for these disparities are varied and that more focused efforts are needed to
address them.
For most individuals who develop kidney failure or end-stage renal disease, kidney
transplantation is the best treatment option. Unfortunately, certain racial and ethnic
groups are less likely to receive kidney transplants than others. Despite the increasing
diversity of patients on dialysis who need kidney transplants, no prior studies had
comprehensively compared the barriers to transplantation among different racial and
ethnic groups.
Yoshio Hall, MD (University of Washington, Seattle) and his colleagues investigated the
rates and determinants of waitlisting and deceased-donor kidney transplantation among
503,090 non-elderly adults of different racial and ethnic groups who initiated dialysis
between 1995 and 2006. They followed the patients through 2008.
The researchers found that the annual crude rates of deceased-donor transplantation
from the time of dialysis initiation were lowest in American Indians/Alaska Natives (2.4%)
and blacks (2.8%), intermediate in Pacific Islanders (3.1%) and Hispanics (3.2%), and
highest in non-Hispanic whites (5.9%) and Asians (6.4%).
The reasons for these differences in rates varied among racial and ethnic groups: blacks,
American Indians, and Alaska Natives face continued difficulty in accessing transplant
waitlists, primarily due to socioeconomic factors, while Hispanics and Pacific Islanders
encounter delays from waitlists, which may be negatively influenced by regional organ
availability, linguistic isolation, and perhaps cultural isolation. “Looking forward, our
study suggests that interventions to address local population-specific barriers to
transplantation may help to reduce overall racial, ethnic, and socioeconomic disparities
in accessing kidney transplantation,” said Dr. Hall. Study co-authors include Ping Xu,
Ann O’Hare, MD (University of Washington, Seattle);
Andy Choi, MD (University of California San Francisco); and Glenn Chertow, MD
(Stanford University).
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