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- Race and social determinants of health were associated with the likelihood of having a kidney transplant in American adults with kidney failure.
- Interventions that target the social determinants of health can improve access to kidney transplantation.
Washington, DC (January 28, 2021) – Among U.S. adults with kidney disease, race and social determinants of health were associated with the likelihood of patients to receive a kidney transplant. The results come from an analysis that will appear in a future issue of Shining.
Blacks are more likely than whites to develop kidney failure, but they are less likely to have a kidney transplant, the optimal treatment for kidney failure. Blacks also have disproportionately lower rates of kidney transplants from living donors, which offer higher patient survival rates and transplants compared to kidney transplants from deceased donors.
To assess whether social determinants of health – such as demographics, cultural factors, psychosocial characteristics, and transplant knowledge – may play a role in these disparities, Larissa Myaskovsky, PhD (University of New Mexico Health Sciences Center ) and his colleagues prospectively followed 1056 patients referred for a kidney transplant from 2010 to 2012 (with follow-up until 2018) at the University of Pittsburgh Medical Center. Patients completed an interview shortly after their initial kidney transplant assessment and were followed until their kidney transplant was completed.
The team found that even after accounting for the social determinants of health, black people had a lower likelihood of receiving a kidney transplant overall, and more specifically a living donor transplant but no donor transplant. deceased.
Black race, older age, lower income, public insurance, more co-morbidities, transplantation before the kidney allocation policy changes in 2014, greater religiosity, less social support, less knowledge about transplantation and less Each learning activity was associated with a lower likelihood of receiving a kidney transplant.
“Our data suggests a critical need for transplant centers to identify and intervene on social determinants for populations at risk,” said Dr. Myaskovsky. “Based on our results, the development of interventions targeting patients with poor knowledge of transplantation, religious objection to living donor transplantation, or poor social support may improve equal access to kidney transplantation. because transplant teams can use these risk factors to target patients who may need support to ensure they receive a transplant. ”
An accompanying editorial from Patient Voice presents the perspective of a black American woman who was suddenly diagnosed with kidney failure 7 years ago at the age of 49. She is a kidney transplant recipient and also director of outreach and government relations for the National Kidney Foundation of Illinois.
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Study co-authors include Hannah Wesselman, BS, C. Graham Ford, MS, Yuridia Leyva, MS, Xingyuan Li, PhD, Chung-Chou H. Chang, PhD, Mary Amanda Dew, PhD, Kellee Kendall, MS , Emilee Croswell, BA, John R. Pleis, PhD, Yue Harn Ng, MD, Mark L. Unruh, MD, and Ron Shapiro, MD.
Disclosures: This work was funded in part by National Institute of Diabetes Digestive and Kidney Diseases (NIDDK) grant number R01DK081325, National Center for Advancing Translational Sciences (NCATS) grant number UL1 TR001857, and DCI grant number C-3924 from Dialysis Clinic Inc. (DCI), a national non-profit dialysis provider.
The article, titled “Social Determinants of Health and Racial Disparities in Kidney Transplantation,” will appear online at http: // cjasn.
The Patient Voice editorial, titled “Barriers to Kidney Transplantation in Racial / Ethnic Minorities,” will be available online at http: // cjasn.
The contents of this article do not reflect the views or opinions of the American Society of Nephrology (ASN). Responsibility for the information and opinions expressed therein rests entirely with the author (s). ASN does not offer medical advice. All the content of ASN’s publications is for information purposes only and is not intended to cover all the uses, instructions, precautions, drug interactions or possible adverse effects. This content should not be used in a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any medication, changing your diet, or starting or stopping any treatment. Do not ignore or delay obtaining professional medical advice because of information accessible via ASN. Call 911 or your doctor for all medical emergencies.
Since 1966, ASN has led the fight to prevent, treat and cure kidney disease around the world by raising awareness among healthcare professionals and scientists, by advancing research and innovation, by communicating new knowledge and by advocating for the highest quality patient care. ASN has more than 21,000 members representing 131 countries. For more information, visit http: // www.
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