Racial Disparities in Renal Allograft Survival: A Public Health Issue?

Eckhoff, Devin E.; Young, Carlton J.; Gaston, Robert S.; Fineman, Steven W.; Deierhoi, Mark H.; Foushee, Margaret T.; Brown, Robert N.; Diethelm, Arnold G.

doi:10.1016/j.jamcollsurg.2007.01.024

Cited by 94 publications

(104 citation statements)

References 36 publications

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“…Patients with AA heritage have been identified as high risk because of poor outcomes after kidney transplant compared with White individuals. 11,[13][14][15][16][17][18][19][20] In contrast, the present analysis found no significant differences in death-censored allograft survival rates between AA and White patients. In addition, our multivariate analysis did not indicate that AA ethnicity was a significant predictor of graft survival.…”

Section: Discussioncontrasting

confidence: 64%

Alemtuzumab Induction Is Associated With an Equalization of Outcomes Between White and African American Kidney Transplant Recipients

Brooks

Mitro²,

DeLeonibus³

et al. 2019

Exp Clin Transplant

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Objectives: Our aim was to assess outcomes in White and African American kidney transplant recipients after induction with alemtuzumab. Materials and Methods:We performed a retrospective study of 464 patients who received deceased-donor kidney transplants and were induced with alem tuzumab between March 2006 and May 2015. We evaluated ethnic influences on patient and graft survival, delayed graft function, allograft failure, and rejection. Results: There were 337 White (67.3%) and 127 African American (25.3%) patients. We observed no significant differences in 1-, 3-, 5-, and 7-year death-censored graft survival. We also observed no significant differences in 1-, 3-, and 5-year patient survival rates. Having African American ethnicity was not a significant predictor of rejection, graft survival, or patient survival. Conclusions: Our results indicate that recipient ethnicity is not a predictor of rejection, graft survival, or patient survival. White and African American kidney transplant recipients induced with alemtuzumab experienced an equalization of outcomes.

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Section: Discussioncontrasting

confidence: 64%

Alemtuzumab Induction Is Associated With an Equalization of Outcomes Between White and African American Kidney Transplant Recipients

Brooks

Mitro²,

DeLeonibus³

et al. 2019

Exp Clin Transplant

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“…The imbalance in the distribution of black patients across the treatment groups, with almost twice as many black patients in the BME group compared with the AME or CsA groups, and the relatively small number of black patients overall preclude definitive conclusions. However, previous studies have implicated higher acute rejection rate and lower allograft survival in black kidney transplant patients treated with calcineurin inhibitor and mycophenolic acid (20,21). The relative efficacy of tofacitinib in black versus non-black patients after kidney transplant and the relationship with exposure warrants further evaluation.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the Effect of Tofacitinib Exposure on Outcomes in Kidney Transplant Patients

Vincenti

Silva

Busque

et al. 2015

American Journal of Transplantation

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“…Blacks have been shown to experience higher mortality, less access to care, higher risk of renal disease progression, fewer referrals for renal transplantation, and shorter renal allograft survival than Whites (1)(2)(3)(4)(5). Some programs aimed at enhancing access to care have shown improvements in this health gap (6,7).…”

mentioning

confidence: 99%

Assessment of Racial Disparities in Chronic Kidney Disease Stage 3 and 4 Care in the Department of Defense Health System

Gao

Oliver

Das

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Racial disparities in provision of healthcare are widespread in the United States but have not been specifically assessed in provision of chronic kidney disease (CKD) care.Design, setting, participants, & measurements: We conducted a retrospective cohort study of the clinical database used in a Department of Defense (DOD) medical system. Beneficiaries studied were DOD-eligible beneficiaries with CKD stage 3 (n ‫؍‬ 7729) and 4 (n ‫؍‬ 589) using the modified Modification of Diet in Renal Disease (MDRD)-estimated GFR formula but requiring manual correction for Black race. Compliance with selected Kidney Disease Outcomes Quality Initiative (KDOQI) CKD recommended targets (monitoring of recommended laboratory data, prescription of recommended medications, and referral to nephrology) was assessed over a 12-mo period, stratified by CKD stage. Logistic regression analysis was used to assess whether race (White, Black, or other) was independently associated with provider compliance with targets, adjusted for demographic factors and burden of comorbid conditions. Results: Among the targets, only monitoring of LDL cholesterol was significantly less common among Blacks. For all other measures, compliance was either not significantly different or significantly higher for Black compared with White beneficiaries. However, patients categorized as "Other" race were in general less likely to achieve targets than Whites, and at stage 3 CKD significantly less likely to achieve targets for monitoring of phosphorous, hemoglobin, and vitamin D.Conclusions: In the DOD health system, provider compliance with selected CKD stage 3 and 4 targets was not significantly lower for Black beneficiaries than for Whites, with the exception of LDL cholesterol monitoring. Patients classified as Other race were generally less likely to achieve targets than Whites, in some patients significantly so.

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Racial Disparities in Renal Allograft Survival: A Public Health Issue?

Cited by 94 publications

References 36 publications

Alemtuzumab Induction Is Associated With an Equalization of Outcomes Between White and African American Kidney Transplant Recipients

Alemtuzumab Induction Is Associated With an Equalization of Outcomes Between White and African American Kidney Transplant Recipients

Evaluation of the Effect of Tofacitinib Exposure on Outcomes in Kidney Transplant Patients

Assessment of Racial Disparities in Chronic Kidney Disease Stage 3 and 4 Care in the Department of Defense Health System

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