Kidney Week

Abstract: FR-PO1031

Factors Impacting Racial Disparity in Kidney Transplant Wait-Listing

Session Information

• Transplantation: Donor-Candidate Assessment and Predictors of Outcome
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Ng, Yue-Harn, University of New Mexico, Albuquerque, New Mexico, United States

Yue-Harn Ng,

• Pankratz, V. Shane, University of New Mexico, Albuquerque, New Mexico, United States

V. Shane Pankratz,

• Bornemann, Kellee, University of Pittsburgh, Pittsburgh, Pennsylvania, United States

Kellee Bornemann,

• Croswell, Emilee J, University of Pittsburgh, Pittsburgh, Pennsylvania, United States

Emilee J Croswell,

• Pleis, John R., University of Pittsburgh, Pittsburgh, Pennsylvania, United States

John R. Pleis,

• Shapiro, Ron, RECANATI/MILLER TRANSPLANTATION INSTITUTE, New York, New York, United States

Ron Shapiro,

• Unruh, Mark L., University of New Mexico, Albuquerque, New Mexico, United States

Mark L. Unruh,

• Myaskovsky, Larissa, University of Pittsburgh, Pittsburgh, Pennsylvania, United States

Larissa Myaskovsky,

Background

African Americans (AA) have a higher incidence of end-stage renal disease but lower rates of kidney transplantation (KT) compared to whites (WH). Disparities persist after adjusting for medical factors. We assessed the relationship of non-medical (eg. cultural, psychosocial, knowledge) factors with KT wait-listing (WL) within the context of racial differences.

Methods

We conducted a longitudinal cohort study with 1057 patients who were referred for KT evaluation. We used Kruskal-Wallis and chi-square test to examine race differences in non-medical factors. We assessed differences in time to KT WL with propensity weight adjustments. We then identified variables associated with early(<100d) vs late WL(>100d).

Results

We found significant racial differences in baseline characteristics[Tab1]. Both with and without propensity weight adjustment, AAs were less likely to be wait-listed compared to WH. This disparity was evident in the late wait-listers[Fig1]. KT knowledge, income and having live donors were positively associated with WL. Age, comorbidities, low SES, and being on dialysis were negatively associated with early WL. Among the late wait-listers, trust in physicians, family loyalty, and social support were positively associated but being AA was negatively associated with WL.

Conclusion

Non-medical factors affect racial disparities in KT WL. Developing interventions targeting cultural and psychosocial factors that put patients at greater risk for later WL may promote equal access to KT.

Fig1

Funding

• NIDDK Support