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Donor race and outcomes in kidney transplant recipients
Author(s) -
Molnar Miklos Z.,
Kovesdy Csaba P.,
Bunnapradist Suphamai,
Streja Elani,
Krishnan Mahesh,
Mucsi Istvan,
Norris Keith C.,
KalantarZadeh Kamyar
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01686.x
Subject(s) - medicine , hazard ratio , dialysis , hemodialysis , kidney transplantation , confidence interval , transplantation , diabetes mellitus , proportional hazards model , logistic regression , kidney disease , surgery , renal function , endocrinology
Background A frican A mericans are at greater risk to reach end‐stage renal disease and this risk may carry over in a kidney transplant recipient after kidney transplantation. Methods Linking the five‐yr patient data of a large dialysis organization to the S cientific R egistry of T ransplant R ecipients , we identified 13 692 hemodialysis patients who underwent first kidney transplantation. Mortality or graft failure and delayed graft function risks were estimated by C ox's regression (hazard ratio [ HR ] and 95% confidence interval) and logistic regression, respectively. Results Patients were 48 ± 14 yr old and included 39% women and 26% patients with diabetes. After adjusting for several relevant clinical and transplant‐related variables, A frican A merican donor race was associated with higher all‐cause mortality, with HR of 1.39 (1.09–1.78) for all‐cause mortality, 1.80 (1.17–2.76) for cardiovascular mortality, 1.30 (1.03–1.64) for death‐censored graft loss and 1.31 (1.10–1.57) for combined outcome over the six‐yr observation period. In the non‐ A frican A merican recipient subcohort, but not in the A frican A merican recipient subcohort, A frican A merican donor race was associated with higher risk of death‐censored graft loss (2.24 [1.44–3.49]) in our fully adjusted model. Conclusions A frican A merican donor race was associated with increased all‐cause and cardiovascular mortality and graft loss.