Nonmedical Attributes Tied to Later Kidney Transplant Waits
African-Americans less likely to be wait-listed; higher income positively associated with wait-listing.
(HealthDay News) -- Nonmedical factors affect racial disparities in kidney transplant (KT) wait-listing, according to a study presented at the annual meeting of the American Society of Nephrology, being held Oct. 31 to Nov. 5 in New Orleans.
Yue-Harn Ng, MD, from the University of New Mexico in Albuquerque, and colleagues assessed racial differences in the relationship between nonmedical (e.g., cultural, psychosocial, knowledge) factors and KT wait-listing among a longitudinal cohort of 1057 patients referred for KT evaluation.
The researchers found significant racial differences in baseline characteristics. African-Americans were less likely to be wait-listed compared to whites, both with and without propensity weight adjustment. This disparity was seen in those who waited more than 100 days to be wait-listed. There was a positive association between wait-listing and nonmedical factors including transplant knowledge, income, and having live donors. Age, comorbidities, low socioeconomic status, and being on dialysis were negatively associated with waiting fewer than 100 days to be wait-listed. For those who waited more than 100 days, trust in physicians, family loyalty, and social support were positively associated with wait-listing, while being African-American was negatively associated with wait-listing.
"Developing interventions targeting cultural and psychosocial factors that put patients at greater risk for later wait-listing may promote equal access to KT," conclude the authors.