Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Racial disparities in kidney transplant: beyond medical factors

Myaskovsky L, Almario D, Dew MA, Switzer GE, Unruh M, Ramkumar M, Shapiro R. Racial disparities in kidney transplant: beyond medical factors. Paper presented at: European Society for Organ Transplantation Annual Meeting; 2010 Apr 19; Rotterdam, Netherlands.




Abstract:

End-stage kidney disease (ESKD) is more common in African Americans (AAs) than European Americans (EAs). AAs also wait longer to receive a kidney transplant (KT) for this disease; and are less likely to receive the optimal treatment, a living donor KT. Reasons for race disparities are poorly understood. This longitudinal study examined how cultural factors (e.g., perceived discrimination, medical mistrust), psychosocial factors (e.g., anxiety, depression), and KT knowledge contributed to race disparities in KT. Patients being evaluated for KT completed telephone interviews after their first transplant clinic appointment, and again after they were accepted or found ineligible for KT. At baseline AA (n = 25) and EA (n = 79) patients were demographically similar, although AAs had lower incomes (t = 2.4, p < .05). AAs reported experiencing significantly more healthcare discrimination, perceived more overall healthcare racism, had higher levels of medical mistrust, lower trust in their physician, greater family loyalty, and more religious objections to KT than EAs (t-tests range = 1.9 to 5.8, all ps < .05). AAs took significantly longer to complete transplant evaluation than EAs (t = 2.1, p < .05). This difference appeared to be accounted for by other factors: linear regression indicated that more experience of healthcare discrimination, higher perceptions of healthcare racism, lower KT knowledge, more depression, and greater trust in their physician predicted longer time to complete evaluation (adjusted R2 = 0.3, p < .001). Logistic regression indicated that higher rates of medical mistrust was the only significant predictor of participants who had a living donor (OR = 3.2, 95% CI = 1.3, 8.3). Cultural and psychosocial factors associated with race contribute to disparities in the duration of KT evaluation. Transplant teams must pay particular attention to such factors in KT candidates in order to help ensure that AAs are not disadvantaged in proceeding through the transplantation process.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.