The Effect of Race and Income on Living Kidney Donation in the United States

被引:87
作者
Gill, Jagbir [1 ,2 ]
Dong, James [1 ]
Rose, Caren [1 ]
Johnston, Olwyn [1 ]
Landsberg, David [1 ]
Gill, John [1 ,2 ,3 ]
机构
[1] Univ British Columbia, Div Nephrol, Vancouver, BC V6Z 1YK, Canada
[2] Univ British Columbia, Ctr Hlth Evaluat & Outcomes Sci, Vancouver, BC V6Z 1YK, Canada
[3] Tufts Univ New England Med Ctr, Boston, MA USA
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2013年 / 24卷 / 11期
关键词
RANDOMIZED CONTROLLED-TRIAL; LIVE ORGAN DONATION; SOCIOECONOMIC-STATUS; RENAL-TRANSPLANTATION; RACIAL DISPARITIES; ACCESS; INTERVENTION; WILLINGNESS; BARRIERS; DISEASE;
D O I
10.1681/ASN.2013010049
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Studies of racial disparities in access to living donor kidney transplantation focus mainly on patient factors, whereas donor factors remain largely unexamined. Here, data from the US Census Bureau were combined with data on all African-American and white living kidney donors in the United States who were registered in the United Network for Organ Sharing (UNOS) between 1998 and 2010 (N=57,896) to examine the associations between living kidney donation (LKD) and donor median household income and race. The relative incidence of LKD was determined in zip code quintiles ranked by median household income after adjustment for age, sex, ESRD rate, and geography. The incidence of LKD was greater in higher-income quintiles in both African-American and white populations. Notably, the total incidence of LKD was higher in the African-American population than in the white population (incidence rate ratio [IRR], 1.20; 95% confidence interval [95% CI], 1.17 to 1.24]), but ratios varied by income. The incidence of LKD was lower in the African-American population than in the white population in the lowest income quintile (IRR, 0.84; 95% CI, 0.78 to 0.90), but higher in the African-American population in the three highest income quintiles, with IRRs of 1.31 (95% CI, 1.22 to 1.41) in Q3, 1.50 (95% CI, 1.39 to 1.62) in Q4, and 1.87 (95% CI, 1.73 to 2.02) in Q5. Thus, these data suggest that racial disparities in access to living donor transplantation are likely due to socioeconomic factors rather than cultural differences in the acceptance of LKD.
引用
收藏
页码:1872 / 1879
页数:8
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