Black Medicaid Recipients Less Likely to Get Living-Donor Kidney: Study
Not one such patient got kidney from living donor over 2.5 years covered by U.S. study
Tuesday, June 25, 2013
In this type of transplant, a living person donates a kidney or part of a kidney to another person.
"Living kidney transplantation is the optimal treatment for patients with end-stage renal disease, offering the best quality of life and longest survival," study lead author Dr. Amber Reeves-Daniel, an assistant professor of nephrology at Wake Forest Baptist Medical Center, said in a center news release.
Blacks comprise 12.6 percent of the U.S. population but about one-third of dialysis patients. Nevertheless, blacks received only 13.5 percent of living kidney transplants performed in 2011, the researchers said.
To determine the reasons for this gap, Reeves-Daniel's team examined data from about 450 white and black patients who received a living kidney transplant at Wake Forest from July 2008 through December 2010.
Patients of either race with private insurance were much more likely than those without private insurance to receive a transplant (22 percent vs. 7.6 percent). Among whites, 27.5 percent of those with private insurance received a transplant, compared to 12.4 percent without private insurance.
But the statistics were more striking among blacks. Those with private insurance were 14 times more likely to receive a transplant than those without private insurance, the study found, and blacks covered by Medicaid were unlikely to receive a living kidney transplant at all.
"An alarming finding is that despite apparent access to kidney transplantation, no African-American Medicaid recipients received a living-donor kidney transplant during the two-and-a-half-year study period," Reeves-Daniel said.
"[It makes sense that] insured patients would be more likely to have donors with sufficient resources to facilitate the processes of living donation," he said. "However, it is difficult to explain why individuals with Medicaid, particularly African-Americans, were so much less likely to receive living kidney transplants."
The study was published online June 20 in the journal Clinical Transplantation.