Disparities exist in kidney transplant timing

January 31, 2013, American Society of Nephrology

African-Americans and individuals without private health insurance are less likely than others to receive a kidney transplant before requiring dialysis, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings indicate that efforts are needed to ensure the equitable distribution of donor kidneys and the timing of transplantation.

While kidney transplantation is the best available therapy for , demand for donor kidneys far exceeds the supply. The longer transplant candidates wait while on dialysis, the worse they do after receiving a transplant. In some areas of the country, the average kidney transplant candidate can wait six years on dialysis before receiving a deceased donor organ. Elsewhere, patients can receive transplants preemptively, or before dialysis is even required.

Morgan Grams, MD (Johns Hopkins University School of Medicine) and her colleagues examined information from all adult first-time deceased donor in the US between 1995 and 2011, classifying them as preemptive, early (on dialysis for one year or less), or late recipients.

Among the major findings:

  • Preemptive recipients were 9% of the total recipient population.
  • Patients with private insurance or a previous (nonkidney) transplant were more likely to receive a preemptive deceased donor kidney transplant.
  • African Americans were 66% less likely than Caucasians to receive a preemptive deceased transplant.
  • Overall, patients transplanted preemptively had similar survival compared with patients transplanted within one year after initiating dialysis.
"We found that, while some regions performed deceased donor preemptive transplants more than others, region was not a big factor in determining preemptive transplant rates," said Dr. Grams. "Rather, we were struck by the disparities by race and insurance type: African American were much less likely to receive prior to requiring dialytic support, as were those with public or no insurance," she added.

The authors noted that given the long wait times for deceased donor kidneys and the fairly comparable survival between patients transplanted preemptively and those transplanted within one year after initiating dialysis, the value of preemptive transplantation from a societal standpoint may be low.

Explore further: Live donor's age has little effect on health of a transplanted kidney

More information: The article, entitled "Preemptive Deceased Donor Kidney Transplantation: Considerations of Equity and Utility," will appear online on January 31, 2013, doi: 10.2215/CJN.05310512

Related Stories

Live donor's age has little effect on health of a transplanted kidney

March 22, 2012
People with kidney failure may think that they're better off getting a new kidney from a young and spry donor, but a recent study indicates that for those over 39 years old, the age of a live donor—ranging from 18 to ...

Race, insurance status related to likelihood of being assessed for kidney transplantation

July 26, 2012
Young black patients and patients without private health insurance are less likely to be assessed for a kidney transplant when they start dialysis, according to a study appearing in an upcoming issue of the Clinical Journal ...

Racial inequalities exist for kids with kidney disease

November 10, 2011
Among children with kidney disease, certain races are less likely to get kidney transplants and are more likely to die than other races, according to two studies from Emory University that were presented during the American ...

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.