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Kidney Week

Abstract: TH-PO1032

Referred Female Patients on Dialysis Are Equally Likely to Receive a Kidney Transplant

Session Information

Category: Women's Health and Kidney Diseases

  • 2200 Women's Health and Kidney Diseases

Authors

  • Walker, Adam G., DaVita Inc, Denver, Colorado, United States
  • Tentori, Francesca, DaVita Inc, Denver, Colorado, United States
  • Weinhandl, Eric D., DaVita Inc, Denver, Colorado, United States
  • Brunelli, Steven M., DaVita Inc, Denver, Colorado, United States
Background

Kidney transplantation continues to be the best option for treating kidney disease; as such, increasing transplant rates remains a high priority. However, variability in transplant access exists for certain patient populations. Several regional United States or small international studies have reported that female dialysis patients are less likely to be referred for transplant than male dialysis patients. Therefore, in this study, we sought to examine whether female patients experience similar inequity in the upstream transplant process after referral.

Methods

This retrospective study used electronic health records and county-level indices of socioeconomic deprivation at the time of dialysis initiation at a kidney care organization in the United States. Patients included in the study (n=35,183) were those who initiated dialysis between July 2015 and June 2018, were 18-80 years old, began care with the kidney care organization within 30 days of first ever dialysis, and had been referred for transplant after dialysis initiation. Patients were followed from date of first eligibility until June 30, 2022, or until censoring. Placement on a transplant waiting list and receipt of transplant were compared across exposure categories using time-to-event models. Models were adjusted for differences in patient demographic factors, comorbidities, laboratory values, and socioeconomic factors across exposure categories, as appropriate.

Results

Hazard ratios and 95% confidence intervals for outcomes are shown in the table below. Results indicate that after adjusting for demographic and socioeconomic factors, compared to male patients, female patients are slightly less like to be placed on a transplant waiting list after referral, but slightly more likely to receive a transplant after waitlisting. The net effect is that female patients referred for transplant were equally likely to receive a transplant compared to male counterparts.

Conclusion

These results demonstrate that females are equally likely to have a successful transplant and increasing referrals for female patients may be one possible solution to increase overall transplant numbers.

Digital Object Identifier (DOI)