Health Disparities in Kidney Transplantation for African Americans

Am J Nephrol. 2017;46(2):165-175. doi: 10.1159/000479480. Epub 2017 Aug 5.

Abstract

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.

Keywords: African American; Call to action; Donor; Education; Gene variants; Health disparities; Kidney transplantation; Outcome.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • African Americans / genetics
  • African Americans / statistics & numerical data*
  • Genetic Testing
  • Graft Rejection / ethnology
  • Graft Rejection / genetics
  • Health Policy*
  • Health Services Accessibility
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / genetics
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / legislation & jurisprudence
  • Kidney Transplantation / methods
  • Kidney Transplantation / statistics & numerical data*
  • Patient Education as Topic
  • Treatment Outcome
  • United States