Survival is better for African American vs. white kidney recipients with obesity
Key takeaways:
- In a mate-kidney study, African American transplant recipients with obesity had a 23% higher risk for graft failure than white recipients.
- However, mortality risk was 30% lower for African American recipients.
SAN DIEGO — Among African American and white adults with obesity who received kidneys from the same deceased donor, graft failure rates were higher — but so were survival rates — for African American recipients, according to study data.
“Our study has shown an improved patient survival in obese African American kidney transplant recipients compared to their white counterparts, which is similar to the observation in dialysis patients,” Kalathil K. Sureshkumar, MD, a nephrologist with the Allegheny Health Network in Pittsburgh, told Healio | Nephrology News & Issues. “[We also found] improved patient survival in African American kidney transplant recipients despite higher comorbidities, including diabetes.”
Using a mate-kidney model, Sureshkumar and colleagues analyzed data on first-time kidney transplants from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database from 2000 to 2023. Researchers identified 3,026 deceased donors for whom one kidney went to an African American recipient with obesity and the other went to a white recipient with obesity (BMI 30 kg/m2). More African American than white recipients had diabetes and hypertension, and African American recipients had a significantly longer duration of dialysis.
Length of hospital stay was similar for both groups. Risk for graft failure with death as a competing risk was higher for African American compared with white recipients (HR = 1.23; 95% CI, 1.05-1.44), but risk for death was lower (HR = 0.7; 95% CI, 0.57-0.86).
Body composition might partly account for the findings if the African American recipients had a greater percentage of fat-free body mass, according to the researchers.
“This study highlights the importance of removing barriers toward access to kidney transplant waiting list especially among African American [patients] who may be obese,” Sureshkumar said.
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Sureshkumar KK, et al. TH-PO728. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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