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Kidney Week

Abstract: SA-PO535

African American Kidney Disease Patients Experience Reduced Access to Genetic Testing Compared With White Patients

Session Information

  • Genetic Diseases: Diagnosis
    November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

  • 1102 Genetic Diseases of the Kidneys: Non-Cystic

Authors

  • Borden, Chloe, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States
  • Tan, Xin Yee, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States
  • Wang, Xiangling, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States
Background

African Americans are almost four times as likely as White Americans to develop kidney failure. In the last decade, significant advancements in the diagnosis and management of patients with genetic kidney diseases have been made. Whether disparities in access to genetic testing between racial groups exists has not been previously examined.

Methods

A retrospective review of patients referred to the Cleveland Clinic Renal Genetics Clinic (RGC) from January 2019 to March 2022 was conducted. Patient demographics, clinical characteristics, insurance coverage, referring providers, diagnostic modality, and diagnostic yield were collected for comparison.

Results

309 patients from 299 pedigrees including 118 males and 191 females aged 35.1 ± 20.3 years were seen at the RGC from January 2019 to March 2022. 49 African American patients, 232 White patients, 24 patients who were neither White nor African American, and 4 patients who declined to provide race were seen. African American patients were significantly more likely to be in end stage renal disease (ESRD) at the time of referral compared with White patients (OR = 3.7, p = 0.003). African American patients were additionally more likely to be covered by Medicaid (OR = 1.4, p = 1.4e-5) and less likely to have private insurance (OR = 0.3, p = 3.3e-4). Further, African American patients were more likely to exhibit nonadherence (OR = 3.4, p = 0.003). No differences in referring providers, family history, diagnostic yield, Medicare coverage, eGFR at first visit, and age at first visit between groups were noted.

Conclusion

This study suggested inequitable access to genetic testing amongst African American kidney disease patients. As personalized genetic healthcare becomes increasingly prevalent, steps will need to be taken to ensure equitable access for all persons.