Highlights
- Pediatric racial minorities are much less likely than whites to get kidney transplants before they need dialysis, regardless of their families' income.
- Among children with kidney failure waiting for a transplant, blacks with no health insurance are more likely to die than whites, while Hispanics are less likely to die than other racial groups regardless of insurance status.
Among children with kidney disease, certain races are less likely to get kidney transplants and are more likely to die than other races, according to two studies from Emory University that were presented during the American Society of Nephrology's Annual Kidney Week.
Kidney transplantation is the optimal treatment for patients with kidney failure, but the demand for organs outweighs the supply. That's why most patients with kidney failure must start on dialysis while they wait for a kidney transplant. Rachel Patzer, PhD and her colleagues looked to see how race and poverty impact access to kidney transplantation before dialysis -- called preemptive transplantation -- among children with kidney failure.
By analyzing data from the United States Renal Data System from 2000 to 2008, the researchers found that the average annual rate of preemptive transplantation was higher among whites than Hispanics and blacks. Racial differences were also evident in the type of preemptive transplants children received, where more white patients had living donors (78.8%) vs Hispanics (57.3%) and blacks (48.8%). Hispanics had a 50% and blacks a 56% lower rate of preemptive transplants than whites.
"Among pediatric kidney disease patients in the United States, white patients have a significantly higher rate of getting a kidney transplant without ever starting dialysis compared to blacks and Hispanics," concluded Dr. Patzer. "The reasons for this racial disparity are not entirely clear, but could be due to lower access to health care among minority patients," she added.
In another study, these same researchers examined racial differences in deaths among children with kidney failure. Sandra Amaral, MD and her team examined all kidney failure patients under 21 years of age who went on dialysis between January 2000 and September 2008 and did not receive a transplant during the study, which ended in September 2009.
Among 8,146 pediatric kidney failure patients, 896 (9.7%) died. Blacks with no health insurance had a 59% greater rate of death after developing kidney failure compared with whites, while Hispanics had a significantly lower rate of death vs the other racial groups regardless of insurance status. "More studies are needed to understand why these differences occur," said Dr. Amaral.
Study authors for "Racial Disparities in Access to Preemptive Kidney Transplantation among the National Pediatric ESRD Population" (abstract TH-PO959) and "Mortality and Race in Pediatric End-Stage Renal Disease: Who Is Dying before Transplant?" (abstract TH-PO630) include Sandra Amaral, MD, Rachel Patzer, PhD, Nancy Kutner, PhD, and William McClellan, MD.
Disclosures available at http://www.asn-online.org/press/.
ASN Kidney Week 2011, the largest nephrology meeting of its kind, will provide a forum for 13,000 professionals to discuss the latest findings in renal research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2011 will take place Nov. 8 – 13 at the Pennsylvania Convention Center in Philadelphia, PA.
The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.
Founded in 1966, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.