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Abstract: TH-PO870

Impact of Area Deprivation Index on Early Stages in the Kidney Transplantation Process

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Snyder, Andrew James, University of Washington School of Medicine, Seattle, Washington, United States
  • Morenz, Anna Marie, University of Washington Department of Medicine, Seattle, Washington, United States
  • Nichols, Jordan, University of Washington School of Medicine, Seattle, Washington, United States
  • Ganzarski, Omri, University of Washington School of Medicine, Seattle, Washington, United States
  • Dick, Andre, University of Washington Department of Surgery, Seattle, Washington, United States
  • Perkins, James D., University of Washington Department of Surgery, Seattle, Washington, United States
  • Kim, Nicole J., University of Washington Department of Medicine, Seattle, Washington, United States
  • Ng, Yue-Harn, University of Washington Department of Medicine, Seattle, Washington, United States
Background

Socioeconomic factors play major roles in kidney transplantation (KT) access and outcomes but are difficult to identify. Area Deprivation Index (ADI) is a measure of socioeconomic conditions at the census block group level. We hypothesized that ADI may be a useful tool to identify patients at risk for inequities in the KT process. We investigated whether ADI was associated with attendance at KT clinic and subsequent waitlisting (WL).

Methods

We performed a retrospective cohort study of adults referred for KT evaluation from 1/1/15 -12/31/21. We compared clinical and sociodemographic characteristics between patients who were 1) seen vs. not seen in KT clinic and 2) WL vs. not WL. Wilcoxon rank sum test for continuous variables and chi-square test for categorical variables were used. Multivariable logistic regression analysis was performed to examine the association between ADI and WL.

Results

2,284 patients were referred for KT evaluation during the study period. Patients from the most vulnerable neighborhoods (ADI 44-100) were less likely to be seen following referral (31% vs 26%; p=0.008). 1,691 (74.0%) patients attended KT evaluation, of these patients, 643 (38%) were waitlisted for KT. Residents in the highest ADI quartile (44-100) had a 38% less odds of being WL relative to the residents in the lowest ADI quartile (1-18) (OR 0.62, 95% CI 0.45-0.87; p=0.005).

Conclusion

Patients residing in higher ADI neighborhoods are at increased risk of not being seen in KT clinic and not being WL after KT evaluation. These findings suggest that ADI may be a useful marker to proactively identify patients at risk for early inequities in advancement through the KT process and could help guide early intervention efforts to ensure a more equitable evaluation process.

Funding

  • NIDDK Support