Blacks Less Likely to Receive Kidney Transplant Early On, Study Finds

People without private insurance also wait longer, research shows

By Mary Elizabeth Dallas

Thursday, January 31, 2013

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THURSDAY, Jan. 31 (HealthDay News) -- Black people and those without private health insurance are less likely than others to receive a kidney transplant before their condition deteriorates to the point that they need dialysis, according to researchers from Johns Hopkins University School of Medicine, in Baltimore.
This racial health disparity shows that more needs to be done to ensure the equitable timing of transplants, the researchers said. They added that the longer patients remain on dialysis, the worse they do after receiving a donor kidney.
"We found that, while some regions performed ... transplants more than others, region was not a big factor in determining preemptive transplant rates," Dr. Morgan Grams said in a university news release.
"Rather, we were struck by the disparities by race and insurance type: African-Americans were much less likely to receive kidney transplantation prior to requiring dialytic support, as were those with public or no insurance."
Demand for donor kidneys exceeds supply of the organs. In some places, patients can wait up to six years for a kidney to become available. In other locations, patients receive a transplant even before they need dialysis.
For the study, published Jan. 31 in the Clinical Journal of the American Society of Nephrology, the researchers analyzed data on deceased adults in the United States who received their first kidney transplant between 1995 and 2011. The patients were divided into two groups: those who received their transplant early and were on dialysis for one year or less and those who received their transplant late.
The study revealed that 9 percent of the transplant recipients received a donor kidney early. The researchers noted that those with private insurance or a previous transplant not involving the kidney were more likely to be treated early on. Black people, the study showed, were 66 percent less likely than white people to receive a transplant before being on dialysis for more than a year.
The study's authors found little difference in survival rates among patients who received a kidney transplant before dialysis and those who had the operation within one year of starting dialysis.
Nearly 90,000 people in the United States are waiting for a kidney transplant. The researchers pointed out that many transplant candidates will die before they receive a donor organ.

SOURCE: American Society of Nephrology, news release, Jan. 31, 2013

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