Health Disparities in Kidney Transplantation for African Americans

被引:70
作者
Harding, Kimberly [1 ]
Mersha, Tesfaye B. [2 ]
Phuong-Thu Pham [3 ]
Waterman, Amy D. [3 ]
Webb, Fern J. [5 ]
Vassalotti, Joseph A. [6 ,7 ]
Nicholas, Susanne B. [3 ,4 ]
机构
[1] Monarch Innovat Partners Inc, Rockville, MD USA
[2] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH USA
[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Nephrol, 900 Veteran Ave,Suite 24-130, Los Angeles, CA 90095 USA
[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Endocrinol, 900 Veteran Ave,Suite 24-130, Los Angeles, CA 90095 USA
[5] Univ Florida, Coll Med, Dept Community Hlth & Family Med, Jacksonville, FL USA
[6] Natl Kidney Fdn Inc, New York, NY USA
[7] Icahn Sch Med Mt Sinai, Dept Med, Div Nephrol, New York, NY 10029 USA
关键词
Kidney transplantation; Health disparities; African American; Donor; Outcome; Gene variants; Call to action; Education; RANDOMIZED CONTROLLED-TRIAL; ELECTRONICALLY MEASURED ADHERENCE; RACIAL DISPARITIES; RENAL-TRANSPLANTATION; ETHNIC DISPARITIES; IMMUNOSUPPRESSIVE MEDICATIONS; EDUCATION; RACE; DISEASE; ACCESS;
D O I
10.1159/000479480
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
Background: The persistent challenges of bridging healthcare disparities for African Americans (AAs) in need of kidney transplantation continue to be unresolved at the national level. This healthcare disparity is multifactorial: stemming from limited kidney donors suitable for AAs; inconsistent care coordination and suboptimal risk factor control; social determinants, low socioeconomic status, reduced access to care; and mistrust of clinicians and the healthcare system. Summary: There are numerous opportunities to significantly lessen the disparities in kidney transplantation for AAs through the following measures: the adoption of new care and patient engagement models that include education, enhanced practice-level cultural sensitivity, and timely referral as well as increased research on the impact of the environment on genetic risk, and implementation of new transplantation-related policies. Key Messages: This systematic review describes pretransplant concerns related to access to kidney transplantation, posttransplant complications, and policy interventions to address the challenging issues associated with kidney transplantation in AAs. (C) 2017 S. Karger AG, Basel
引用
收藏
页码:165 / 175
页数:11
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