Comparison of longer-term outcomes after kidney transplantation between hispanic and non-hispanic whites in the United States

C. M. Arce, C. R. Lenihan, M. E. Montez-Rath, W. C. Winkelmayer

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

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 (aHRCS) for mortality and all-cause graft failure and subdistribution hazard ratios (aHRSD) accounting for death as a competing risk for graft failure excluding death with a functioning graft. Both mortality [aHRCS = 0.69 (0.65-0.73)] and all-cause graft failure [aHRCS = 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 [aHRSD = 0.96 (0.89-1.05)] or aged 40-59 years [aHRSD = 1.08 (1.00-1.16)], but was 13% lower in those aged ≥60 years [aHRSD = 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.

Original languageEnglish (US)
Pages (from-to)499-507
Number of pages9
JournalAmerican Journal of Transplantation
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • disparities
  • epidemiology
  • health services and outcomes research
  • kidney transplantation/nephrology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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