Dataset Information

Differences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.

ABSTRACT:

Background and objectives

Hispanic patients undergoing chronic dialysis are less likely to receive a kidney transplant compared with non-Hispanic whites. This study sought to elucidate disparities in the path to receipt of a deceased donor transplant between Hispanic and non-Hispanic whites.

Design, setting, participants, & measurements

Using the US Renal Data System, 417,801 Caucasians who initiated dialysis between January 1, 1995 and December 31, 2007 with follow-up through 2008 were identified. This study investigated time from first dialysis to first kidney transplantation, time from first dialysis to waitlisting, and time from waitlisting to kidney transplantation. Multivariable Cox regression estimated cause-specific hazard ratios (HRCS) and subdistribution (competing risk) hazard ratios (HRSD) for Hispanics versus non-Hispanic whites.

Results

Hispanics experienced lower adjusted rates of deceased donor kidney transplantation than non-Hispanic whites (HRCS, 0.77; 95% confidence interval [95% CI], 0.75 to 0.80) measured from dialysis initiation. No meaningful differences were found in time from dialysis initiation to placement on the transplant waitlist. Once waitlisted, Hispanics had lower adjusted rates of deceased donor kidney transplantation (HRCS, 0.66; 95% CI, 0.64 to 0.68), and the association attenuated once accounting for competing risks (HRSD, 0.79; 95% CI, 0.77 to 0.81). Additionally controlling for blood type and organ procurement organization further reduced the disparity (HRSD, 0.99; 95% CI, 0.96 to 1.02).

Conclusions

After accounting for geographic location and controlling for competing risks (e.g., Hispanic survival advantage), the disparity in access to deceased donor transplantation was markedly attenuated among Hispanics compared with non-Hispanic whites. To overcome the geographic disparities that Hispanics encounter in the path to transplantation, organ allocation policy revisions are needed to improve donor organ equity.

SUBMITTER: Arce CM

PROVIDER: S-EPMC3848391 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Differences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.

Arce Cristina M CM Goldstein Benjamin A BA Mitani Aya A AA Lenihan Colin R CR Winkelmayer Wolfgang C WC

Clinical journal of the American Society of Nephrology : CJASN 20131010 12

<h4>Background and objectives</h4>Hispanic patients undergoing chronic dialysis are less likely to receive a kidney transplant compared with non-Hispanic whites. This study sought to elucidate disparities in the path to receipt of a deceased donor transplant between Hispanic and non-Hispanic whites.<h4>Design, setting, participants, & measurements</h4>Using the US Renal Data System, 417,801 Caucasians who initiated dialysis between January 1, 1995 and December 31, 2007 with follow-up through 200 ...[more]

PMID: 24115195

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Dataset Information

Differences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.

Background and objectives

Design, setting, participants, & measurements

Results

Conclusions

Publications

Differences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.

Similar Datasets

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