Canadian Renal Transplant Data Show Race Disparities

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Kidney Int. 2007;72:499-504

 

Among Canadian dialysis patients, those of East Asian and Indo Asian origin are less likely to receive a renal transplant than white patients, data show.

 

Marcello Tonelli, MD, of the University of Alberta in Edmon-ton, and his colleagues studied 21,523 adults who had initiated dialysis in Canada from 1990 to 2000. Of these, 1,243 (6%) were East Asian, 736 (3%) were Indo Asian, and 19,544 (91%) were white. A total of 5,524 (25%) received a transplant, 1,350 (25%) from living donors.

 

The adjusted transplant rates per 100 patient-years during the study period were 4.5, 4.4, and 6.3 for East Asian, Indo Asian, and white patients, respectively. In addition, among patients receiving a transplant, the percentage originating from a living donor was 12% among East Asian recipients, which was significantly lower than the percentage for either Indo Asian (20%) or white (26%) recipients.

 

Compared with white patients, East Asians and Indo Asians were 29% and 31% less likely to receive a transplant, after adjusting for age, gender, primary cause of end-stage renal disease, year of diagnosis, comorbidities, and potential confounders. Moreover, East Asians and Indo Asians were 73% and 58% less likely to receive a live donor transplant. The likelihood of graft failure was similar across the three groups.

 

East Asians and Indo Asians were 28% and 56% less likely to die following transplantation. East Asian patients were more likely to have glomerulonephritis as the cause of kidney failure and had less comorbidity such as coronary disease or chronic heart failure compared with Indo Asians and whites, the research-ers reported. Additionally, East Asians and Indo Asians were more likely to live in low income neighborhoods and less likely to live in a rural area.

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