Race/ethnicity, poverty status, and renal transplant outcomes

Rebecca Press, Olveen Carrasquillo, Thomas Nickolas, Jai Radhakrishnan, Steven Shea, R. Graham Barr

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background. There are known racial disparities in renal graft survival. Data are lacking comparing associations of race/ethnicity and socioeconomic status with graft failure and functional status after transplantation. Our goal was to test if African-American and Hispanic race/ethnicity and poverty are associated with worse outcomes following renal transplantation. Methods. We performed a retrospective cohort study using a nationwide registry (United Network for Organ Sharing). We studied 4,471 adults who received renal transplants in 1990. Outcomes were graft failure and functional status over 10 years. Results. Cumulative incidence of graft failure was higher among African-Americans and Hispanics than whites (77% vs. 64% vs. 60 %; P<0.001) and among transplant recipients living in the poorest areas (70% vs. 58% in the richest; P<0.001). African-American and Hispanic race/ethnicity were independently predictive of graft failure (RR 1.8, 95% CI 1.6-1.9; RR 1.3, 95% CI 1.2-1.6, respectively) in multivariate analyses but poverty status was not (RR 1.0, 95% CI 0.9-1.1). Days with impaired functional status were higher for African-Americans compared to whites (RR 1.6,95% CI 1.3-1.9) but not independent of poverty. Poverty was independently associated with impaired functional status (RR 1.3, 95% CI 1.0-1.6). Conclusions. African-Americans and Hispanics had higher rates of graft failure compared to whites after adjustment for poverty and other covariates whereas poverty, but not race/ethnicity, was related to functional status following renal transplantation. National datasets should include individual-level measures of socioeconomic status in order to improve evaluation of social and environmental causes of disparities in renal transplant outcomes.

Original languageEnglish
Pages (from-to)917-924
Number of pages8
JournalTransplantation
Volume80
Issue number7
DOIs
StatePublished - Oct 15 2005
Externally publishedYes

Fingerprint

Poverty
African Americans
Transplants
Kidney
Hispanic Americans
Social Class
Kidney Transplantation
Graft Survival
Registries
Cohort Studies
Multivariate Analysis
Retrospective Studies
Transplantation
Incidence

Keywords

  • Databases
  • Kidney transplantation
  • Socioeconomic factors

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Press, R., Carrasquillo, O., Nickolas, T., Radhakrishnan, J., Shea, S., & Barr, R. G. (2005). Race/ethnicity, poverty status, and renal transplant outcomes. Transplantation, 80(7), 917-924. https://doi.org/10.1097/01.tp.0000173379.53347.31

Race/ethnicity, poverty status, and renal transplant outcomes. / Press, Rebecca; Carrasquillo, Olveen; Nickolas, Thomas; Radhakrishnan, Jai; Shea, Steven; Barr, R. Graham.

In: Transplantation, Vol. 80, No. 7, 15.10.2005, p. 917-924.

Research output: Contribution to journalArticle

Press, R, Carrasquillo, O, Nickolas, T, Radhakrishnan, J, Shea, S & Barr, RG 2005, 'Race/ethnicity, poverty status, and renal transplant outcomes', Transplantation, vol. 80, no. 7, pp. 917-924. https://doi.org/10.1097/01.tp.0000173379.53347.31
Press, Rebecca ; Carrasquillo, Olveen ; Nickolas, Thomas ; Radhakrishnan, Jai ; Shea, Steven ; Barr, R. Graham. / Race/ethnicity, poverty status, and renal transplant outcomes. In: Transplantation. 2005 ; Vol. 80, No. 7. pp. 917-924.
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AU - Press, Rebecca

AU - Carrasquillo, Olveen

AU - Nickolas, Thomas

AU - Radhakrishnan, Jai

AU - Shea, Steven

AU - Barr, R. Graham

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N2 - Background. There are known racial disparities in renal graft survival. Data are lacking comparing associations of race/ethnicity and socioeconomic status with graft failure and functional status after transplantation. Our goal was to test if African-American and Hispanic race/ethnicity and poverty are associated with worse outcomes following renal transplantation. Methods. We performed a retrospective cohort study using a nationwide registry (United Network for Organ Sharing). We studied 4,471 adults who received renal transplants in 1990. Outcomes were graft failure and functional status over 10 years. Results. Cumulative incidence of graft failure was higher among African-Americans and Hispanics than whites (77% vs. 64% vs. 60 %; P<0.001) and among transplant recipients living in the poorest areas (70% vs. 58% in the richest; P<0.001). African-American and Hispanic race/ethnicity were independently predictive of graft failure (RR 1.8, 95% CI 1.6-1.9; RR 1.3, 95% CI 1.2-1.6, respectively) in multivariate analyses but poverty status was not (RR 1.0, 95% CI 0.9-1.1). Days with impaired functional status were higher for African-Americans compared to whites (RR 1.6,95% CI 1.3-1.9) but not independent of poverty. Poverty was independently associated with impaired functional status (RR 1.3, 95% CI 1.0-1.6). Conclusions. African-Americans and Hispanics had higher rates of graft failure compared to whites after adjustment for poverty and other covariates whereas poverty, but not race/ethnicity, was related to functional status following renal transplantation. National datasets should include individual-level measures of socioeconomic status in order to improve evaluation of social and environmental causes of disparities in renal transplant outcomes.

AB - Background. There are known racial disparities in renal graft survival. Data are lacking comparing associations of race/ethnicity and socioeconomic status with graft failure and functional status after transplantation. Our goal was to test if African-American and Hispanic race/ethnicity and poverty are associated with worse outcomes following renal transplantation. Methods. We performed a retrospective cohort study using a nationwide registry (United Network for Organ Sharing). We studied 4,471 adults who received renal transplants in 1990. Outcomes were graft failure and functional status over 10 years. Results. Cumulative incidence of graft failure was higher among African-Americans and Hispanics than whites (77% vs. 64% vs. 60 %; P<0.001) and among transplant recipients living in the poorest areas (70% vs. 58% in the richest; P<0.001). African-American and Hispanic race/ethnicity were independently predictive of graft failure (RR 1.8, 95% CI 1.6-1.9; RR 1.3, 95% CI 1.2-1.6, respectively) in multivariate analyses but poverty status was not (RR 1.0, 95% CI 0.9-1.1). Days with impaired functional status were higher for African-Americans compared to whites (RR 1.6,95% CI 1.3-1.9) but not independent of poverty. Poverty was independently associated with impaired functional status (RR 1.3, 95% CI 1.0-1.6). Conclusions. African-Americans and Hispanics had higher rates of graft failure compared to whites after adjustment for poverty and other covariates whereas poverty, but not race/ethnicity, was related to functional status following renal transplantation. National datasets should include individual-level measures of socioeconomic status in order to improve evaluation of social and environmental causes of disparities in renal transplant outcomes.

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KW - Kidney transplantation

KW - Socioeconomic factors

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