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Comparison of Longer‐Term Outcomes After Kidney Transplantation Between Hispanic and Non‐Hispanic Whites in the United States
Author(s) -
Arce C. M.,
Lenihan C. R.,
MontezRath M. E.,
Winkelmayer W. C.
Publication year - 2015
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.13043
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , kidney transplantation , cause of death , population , transplantation , surgery , demography , disease , environmental health , sociology
Little is known about the longer‐term kidney transplant outcomes in the rapidly growing Hispanic population. Using the United States Renal Data System, we identified 105 250 Caucasian patients who received a first kidney transplant between January 1, 1996 and December 31, 2010. We tested for differences between Hispanic and non‐Hispanic patients in the outcomes of (1) mortality, (2) all‐cause graft failure, and (3) graft failure excluding death with a functioning graft. We used Cox regression to estimate (with 95% confidence intervals) multivariable‐adjusted cause‐specific hazard ratios (aHR CS ) for mortality and all‐cause graft failure and subdistribution hazard ratios (aHR SD ) accounting for death as a competing risk for graft failure excluding death with a functioning graft. Both mortality [aHR CS = 0.69 (0.65–0.73)] and all‐cause graft failure [aHR CS = 0.79 (0.75–0.83)] were lower in Hispanics. The association between Hispanic ethnicity and graft failure excluding death was modified by age (p < 0.003). Compared with non‐Hispanic whites, graft failure excluding death with a functioning graft did not differ in Hispanics aged 18–39 years [aHR SD = 0.96 (0.89–1.05)] or aged 40–59 years [aHR SD = 1.08 (1.00–1.16)], but was 13% lower in those aged ≥60 years [aHR SD = 0.87 (0.78–0.98)]. In conclusion, once accounting for differences in overall survival, better graft survival was found in older Hispanic patients, but among not those aged <60 years.