Racial disparities exist in children's access to kidney transplantation

December 29, 2016

Washington, DC (December 29, 2016) -- Researchers have uncovered a higher risk of death in black vs. white children with kidney failure over the last two decades that seems to be mediated by differences in access to kidney transplantation. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), point to the need to develop strategies that will ensure equal access to transplantation for children.

Children with kidney failure are given high priority in the allocation of deceased donor kidneys because kidney disease interferes with normal growth. It's unclear if some children face racial disparities in this allocation, however.

To investigate whether there are racial disparities in the survival of children with kidney failure, Elaine Ku, MD (University of California San Francisco) and her colleagues analyzed information on 12,123 non-Hispanic black, Hispanic, and non-Hispanic white children who started renal replacement therapy (either dialysis or transplantation) between 1995 and 2011 and were followed up through 2012.

During a median follow-up of 7.1 years, 1600 children died. Black children had a 36% higher risk of death than white children, which was mostly attributed to differences in access to transplantation. Hispanic children had lower risk of death than non-Hispanic white children even though they had lower access to transplantation. Also, when investigators accounted for black children's reduced access to transplantation, there was no longer an appreciable difference in survival in black and white children.

"We believe it is critically important to understand differences in transplantation and death by race so that changes can be made to either the allocation of donated organs or current practices in the treatment of kidney disease in children to eliminate the differences that we observed," said Dr. Ku.
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Study co-authors include Kirsten Johansen, MD, Charles McCulloch, PhD, and Barbara Grimes, PhD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Racial disparities in survival of children with end-stage renal disease," will appear online at http://jasn.asnjournals.org/ on December 29, 2016, doi: 10.1681/ASN.2016060706.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 16,000 members representing 112 countries. For more information, please visit http://www.asn-online.org or contact us at 202-640-4660.

American Society of Nephrology

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