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SES Mediates Racial Differences in Kidney Transplant Listing

Socioeconomic status and comorbidity attenuate racial differences in transplant listing, not receipt

THURSDAY, May 7, 2020 (HealthDay News) — Among patients with kidney failure, accounting for socioeconomic status (SES) and comorbidity attenuates racial disparities in listing for, but not receipt of, kidney transplant, according to a study published online May 7 in the Clinical Journal of the American Society of Nephrology.

Karly A. Murphy, M.D., from the Johns Hopkins School of Medicine in Baltimore, and colleagues studied a prospective cohort of 3,013 kidney failure patients referred for and who started the transplant process (2009 to 2018) to examine the contributions of SES and comorbidities as mediators to disparities in listing and transplant.

The researchers found that 60 and 66 percent of black and white patients, respectively, were waitlisted within the first year. The adjusted chance of listing was attenuated from 0.76 to 0.90 for black versus white patients after accounting for SES and comorbidity. SES, comorbidity, and SES plus comorbidity attenuated 36, 44, and 58 percent of the racial disparity in listing, respectively. The incidence rate of transplant was 19 and 24 per 100 person-years for black and white candidates, respectively, among 2,109 listed candidates. Four percent of the disparity was attenuated by measured SES and comorbidity, but these factors did not attenuate the adjusted rate ratio for transplant.

“Efforts to eliminate racial disparities in listing for transplant may wish to focus on barriers that candidates with low SES and high comorbidity will face,” the authors write.

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