African-Americans and individuals without private health insurance are less likely than others to receive a kidney transplant before requiring dialysis, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings indicate that efforts are needed to ensure the equitable distribution of donor kidneys and the timing of transplantation.
While kidney transplantation is the best available therapy for kidney failure, demand for donor kidneys far exceeds the supply. The longer transplant candidates wait while on dialysis, the worse they do after receiving a transplant. In some areas of the country, the average kidney transplant candidate can wait six years on dialysis before receiving a deceased donor organ. Elsewhere, patients can receive transplants preemptively, or before dialysis is even required.
Morgan Grams, MD (Johns Hopkins University School of Medicine) and her colleagues examined information from all adult first-time deceased donor kidney transplant recipients in the US between 1995 and 2011, classifying them as preemptive, early (on dialysis for one year or less), or late recipients.