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Abstract: TH-PO740

Racism, Discrimination, and Kidney Transplant Success in the Southern United States

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Anand, Prince Mohan, Medical University of South Carolina, Charleston, South Carolina, United States
  • Browne, Teri, University of South Carolina System, Columbia, South Carolina, United States
Background

Kidney transplant racial disparities are prevalent in the United States. African Americans are almost half as likely as White patients to receive a kidney transplant. No previous research in the Southern U.S. (with the greatest transplant disparities) has focused on African American patients' lived experiences with racism, racial prejudice, and discrimination and their impact on kidney transplant parity. This study examines these phenomena and can inform future research and interventions to increase kidney transplant parity.

Methods

This community-engaged and interdisciplinary project uses qualitative content analyses of in-depth interviews with 100 African Americans who are on dialysis or have chronic kidney disease in a southern US state. We used a combination of deductive and inductive approaches for analyses, establishing a preliminary codebook of provisional codes guided by our interview prompts. We then added emergent codes to the provisional codebook, iteratively refining the codebook. Data are analyzed qualitatively using MAXQDA software.

Results

The most prominent themes that emerged from the analyses included the impact of racism and discrimination on 1. access to kidney transplants, 2. gaps in education, understanding, and awareness of kidney transplant, and 3. the quality of life of people living with kidney disease. Most respondents desire a kidney transplant (80%), few express concerns about transplantation (18%), but < 1/3 (29%) were referred for transplant evaluation. Few patients report receiving information from their kidney health providers on how to obtain a kidney. Most patients demonstrated limited knowledge and awareness regarding the kidney transplantation process. Many respondents also report that White patients are treated better than them, often attributing these patterns of differential treatment to differences in class (e.g., income, poverty), race, or residential context (e.g., rural, suburb, urban).

Conclusion

Racial disparities have long existed in kidney transplantation, yet the impact of racism and discrimination on these health inequities is under-studied. This study can offer insight into new interventions and research to help improve kidney transplant parity, and findings can also help inform interdisciplinary practice in dialysis and transplant centers.