Factors Influencing Kidney Transplantation Access in the United States: A Comprehensive Analysis of National Data

Document Type

Conference Proceeding

Publication Date

2-2025

Publication Title

American Journal of the Medical Sciences

Abstract

Purpose: Kidney transplantation is a critical treatment for end-stage renal disease, offering improved quality of life and survival rates. Understanding the factors influencing access to this life-saving procedure is crucial for ensuring equitable healthcare delivery in the United States. Methods: We conducted a retrospective analysis using the National Inpatient Sample database from Jan, 2016 to Dec, 2020. The study included 99,010 renal transplant patients (95% CI: 91,538–106,482). The mean age was 50.6 years (95% CI: 50.3–50.9), with 56,180 males and 42,830 females. Analyses were adjusted for age, income, hospital region, and various comorbidities including hypertension, type 2 diabetes, heart failure, coronary artery disease, obesity, chronic kidney disease, peripheral vascular disease, obstructive sleep apnea, and COPD. Results: Our analysis revealed significant variations in kidney transplantation rates across different demographic and socioeconomic factors. Females had lower odds of receiving a kidney transplant compared to males (adjusted OR: 0.673, p < 0.00001). Racial disparities were observed, with Asians (OR 2.43, p < 0.001), Hispanics (OR 1.53, p < 0.001), and African Americans (OR 1.23, p < 0.001) showing higher odds of transplantation compared to Caucasians. Insurance type played a crucial role, with all types showing lower odds compared to Medicare, particularly self-pay (OR 0.043, p < 0.001) and Medicaid (OR 0.128, p < 0.001). Hospital characteristics also significantly influenced transplantation rates, with urban teaching hospitals showing dramatically higher odds (OR 160.32, p < 0.001) compared to rural hospitals. Conclusions: Our findings reveal significant disparities based on gender, race, insurance type, and hospital characteristics, highlighting the multifaceted nature of healthcare access in the context of organ transplantation.

Volume

369

Issue

Suppl 1

First Page

S365

Comments

Southern Regional Meeting, February 13-15, 2025, New Orleans, LA

Last Page

S366

DOI

10.1016/S0002-9629(25)00565-8

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