Socioeconomic Inequities in Kidney Transplantation
Author Information
Author(s): Kizilbash Sarah MD, Wi Chung-II MD, Roy Madison MS, Ryu Euijung PhD, Matas Arthur MD, Garovic Vesna MD, PhD, Riad Samy MD, MS, Schinstock Carrie MD, Juhn Young MD
Primary Institution: University of Minnesota
Hypothesis
Lower socioeconomic status (SES) recipients will have fewer preemptive transplants, longer pretransplant dialysis duration, and increased hazards of graft loss.
Conclusion
The study found significant socioeconomic disparities in kidney transplant access, dialysis duration, and graft survival, suggesting that the HOUSES index can help identify individuals at risk.
Supporting Evidence
- Lower SES recipients had a decreased likelihood of receiving preemptive transplants.
- Lower SES was associated with longer pretransplant dialysis duration.
- Lower SES recipients experienced higher death-censored graft loss.
Takeaway
People with less money and resources have a harder time getting kidney transplants and keeping their new kidneys healthy.
Methodology
The study used mixed-effects multivariable logistic and Cox models to analyze data from kidney transplant recipients in Minnesota between 2010 and 2020.
Potential Biases
Potential misclassification bias due to reliance on address-based SES measures.
Limitations
The study is retrospective and may not account for unknown confounders; it also had a higher proportion of non-Hispanic White patients, limiting generalizability.
Participant Demographics
Mean age at transplant was 51.7 years; 60.6% were men, and 76.6% were White.
Statistical Information
P-Value
0.03
Confidence Interval
0.57-0.97
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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