Racial gaps persist in kidney transplantation, particularly among younger patients
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Key takeaways:
- Non-Hispanic Black patients were less likely to be put on waitlists vs. non-Hispanic white patients.
- The largest disparity in waitlist placement was among patients aged 18 to 29 years, researchers found.
Evident racial gaps in transplant waitlist placement between Black and white patients exist, particularly among younger individuals with kidney failure, new data suggests.
“Racial disparities exist at all steps of the kidney transplant process, including waitlisting,” Jade Buford, MPH, of the Emory University School of Medicine in Atlanta, and lead researcher, told Healio. “The purpose of this study was to examine whether racial disparities in kidney transplant waitlisting vary by age of the patient with kidney failure.”
Researchers conducted a retrospective cohort trial using data from the United States Renal Data System to follow 439,455 “non-Hispanic” white and “non-Hispanic” Black adults who started dialysis between 2015 and 2019. They compared waitlist rates between racial groups within different age strata. Primary outcome was placement on the United Network for Organ Sharing deceased donor waitlist.
Overall, non-Hispanic Black patients were less likely to be on a waitlist vs. non-Hispanic white patients, the results showed. After 1 year, non-Hispanic white and non-Hispanic Black patients were waitlisted at 20.7% and 20.5%, respectively, and non-Hispanic Black patients were 14% less likely to be waitlisted.
Researchers found “racial disparities in waitlisting between non-Hispanic Black and non-Hispanic white individuals were most pronounced among younger patients with kidney failure,” according to Buford. The largest disparity in waitlist placement was among patients aged 18 to 29 years, according to the study. Non-Hispanic Black patients in this group were 27% less likely to be waitlisted vs. their non-Hispanic white peers.
Waitlist disparities between the two racial groups were less apparent among patients aged 30 to 49 years, with non-Hispanic Black patients in this group being 11% less likely to be waitlisted, according to the study. For patients aged 50 to 64 years and aged 65 to 80 years, non-Hispanic Black patients were 12% and 20% less likely to be waitlisted, each.
“Understanding the reasons for these differences in racial disparities by age can help inform future interventions and policies to improve access where disparities exist. Health care systems could develop strategies to address the specific barriers faced by young Black patients,” Buford said. “Further, the identification of age-related variations in racial disparities could lead to the development of policies or allocation of resources that specifically address the unique barriers faced by different age groups.”
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