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Social Factors in Health Tied to Odds of Kidney Transplant

FRIDAY, Jan. 29, 2021 -- Social determinants of health and race are associated with the likelihood of undergoing kidney transplant, according to a study published online Jan. 28 in the Clinical Journal of the American Society of Nephrology.

Hannah Wesselman, from the University of Notre Dame in Indiana, and colleagues prospectively followed 1,056 patients referred for kidney transplant (2010 to 2012) until their kidney transplant. The cumulative incidence of receipt of any kidney transplant, deceased-donor transplant, or living-donor transplant was estimated, and factors associated with each outcome were examined.

The researchers found that Blacks had a lower likelihood of receiving a kidney transplant (subdistribution hazard ratio [SHR], 0.74; 95 percent confidence interval, 0.55 to 0.99) and living-donor transplant (SHR, 0.49; 95 percent confidence interval, 0.26 to 0.95), but not a deceased-donor transplant (SHR, 0.92; 95 percent confidence interval, 0.67 to 1.26), even after accounting for social determinants of health. A lower probability of any kidney transplant was seen in association with Black race, older age, lower income, public insurance, more comorbidities, being transplanted before the Kidney Allocation System (KAS), greater religiosity, less social support, less transplant knowledge, and fewer learning activities. The probability of undergoing deceased-donor transplant was lower in association with older age, more comorbidities, being transplanted pre-KAS, greater religiosity, less social support, and fewer learning activities.

"Our data suggest a critical need for transplant centers to identify and intervene on social determinants for at-risk populations," a coauthor said in a statement.

One author is employed by Eli Lilly and Company.

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