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Author Notes:
E-mail address: rpatzer@emory.edu.
The authors of this manuscript have no competing financial interests to disclose.
Subjects:
Research Funding:
R.E.P. was supported in part by grants from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number ULl TR000454 and KL2TR000455 as well as R24MD008077 through the National Institute on Minority Health and Health Disparities.
S.A. is supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases K23-DK083529.
Keywords:
- Science & Technology
- Life Sciences & Biomedicine
- Urology & Nephrology
- clinical epidemiology
- end-stage renal disease
- kidney transplantation
- racial disparities
- transplant outcomes
- United States Renal Data system
- KIDNEY-TRANSPLANT RECIPIENTS
- GRAFT-SURVIVAL
- AFRICAN-AMERICAN
- SOCIOECONOMIC-STATUS
- ACCESS
- OUTCOMES
- TERM
- DISEASE
- AGE
- PHARMACOKINETICS
Racial and ethnic disparities in pediatric renal allograft survival in the United States
Abstract:
This study was undertaken to describe the association of patient race/ethnicity and renal allograft survival among the national cohort of pediatric renal allograft recipients. Additionally, we determined whether racial and ethnic differences in graft survival exist among individuals living in low- or high-poverty neighborhoods and those with private or public insurance. Among 6216 incident, pediatric end-stage renal disease patients in the United States Renal Data System (kidney transplant from 2000 through September, 2011), 14.4% experienced graft failure, with a median follow-up time of 4.5 years. After controlling for multiple covariates, black race, but not Hispanic ethnicity, was significantly associated with a higher rate of graft failure for both deceased and living donor transplant recipients. Disparities were particularly stark by 5 years post transplant, when black living donor transplant recipients experienced only 63.0% graft survival compared with 82.8 and 80.8% for Hispanics and whites, respectively. These disparities persisted among high- and low-poverty neighborhoods and among both privately and publicly insured patients. Notably profound declines in both deceased and living donor graft survival rates for black, compared with white and Hispanic, children preceded the 3-year mark when transplant Medicare eligibility ends. Further research is needed to identify the unique barriers to long-term graft success among black pediatric transplant recipients.
Copyright information:
© 2014 International Society of Nephrology.
This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).
