TY - JOUR
T1 - Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
AU - Lui, Eric
AU - Gill, Jasleen
AU - Hamid, Marzan
AU - Wen, Cindy
AU - Singh, Navneet
AU - Okoh, Princess
AU - Xu, Xihui
AU - Boakye, Priscilla
AU - James, Carl E.
AU - Waterman, Amy D.
AU - Edwards, Beth
AU - Mucsi, Istvan
N1 - Publisher Copyright:
© 2024 International Society of Nephrology
PY - 2024/4
Y1 - 2024/4
N2 - Introduction: Both immigrant and racialized status may be associated with the pursuit of living donor kidney transplant (LDKT). Methods: This study was a secondary analysis of a convenience cross-sectional sample of patients with kidney failure in Toronto, obtained from our “Comprehensive Psychosocial Research Data System” research database. The exposures included racialized, immigrant, and combined immigrant and racialized status (White nonimmigrant, racialized nonimmigrant, White immigrant and racialized immigrant). Outcomes include the following: (i) having spoken about LDKT with others, (ii) having a potential living donor (LD) identified, (iii) having allowed others to share the need for LDKT, (iv) having directly asked a potential donor to be tested, and (v) accept a hypothetical LDKT offer. We assessed the association between exposure and outcomes using univariable, and multivariable binary or multinominal logistic regression (reference: White or White nonimmigrant participants). Results: Of the 498 participants, 281 (56%) were immigrants; 142 (28%) were African, Caribbean, and Black (ACB); 123 (25%) were Asian; and 233 (47%) were White. Compared to White nonimmigrants, racialized immigrants (relative risk ratio [RRR]: 2.98; 95% confidence interval [CI]: 1.76–5.03) and racialized nonimmigrants (RRR: 2.84; 95% CI: 1.22–6.65) were more likely not to have spoken about LDKT with others (vs. having spoken or planning to do so). Both racialized immigrant (odds ratio [OR]: 4.07; 95% CI: 2.50–6.34), racialized nonimmigrants (OR: 2.68; 95% CI: 1.31–5.51) and White immigrants (OR: 2.68; 95% CI: 1.43–5.05) were more likely not to have a potential LD identified. Conclusion: Both racialized and immigrant status are associated with less readiness to pursue LDKT. Supporting patients to communicate their need for LDKT may improve equitable access to LDKT.
AB - Introduction: Both immigrant and racialized status may be associated with the pursuit of living donor kidney transplant (LDKT). Methods: This study was a secondary analysis of a convenience cross-sectional sample of patients with kidney failure in Toronto, obtained from our “Comprehensive Psychosocial Research Data System” research database. The exposures included racialized, immigrant, and combined immigrant and racialized status (White nonimmigrant, racialized nonimmigrant, White immigrant and racialized immigrant). Outcomes include the following: (i) having spoken about LDKT with others, (ii) having a potential living donor (LD) identified, (iii) having allowed others to share the need for LDKT, (iv) having directly asked a potential donor to be tested, and (v) accept a hypothetical LDKT offer. We assessed the association between exposure and outcomes using univariable, and multivariable binary or multinominal logistic regression (reference: White or White nonimmigrant participants). Results: Of the 498 participants, 281 (56%) were immigrants; 142 (28%) were African, Caribbean, and Black (ACB); 123 (25%) were Asian; and 233 (47%) were White. Compared to White nonimmigrants, racialized immigrants (relative risk ratio [RRR]: 2.98; 95% confidence interval [CI]: 1.76–5.03) and racialized nonimmigrants (RRR: 2.84; 95% CI: 1.22–6.65) were more likely not to have spoken about LDKT with others (vs. having spoken or planning to do so). Both racialized immigrant (odds ratio [OR]: 4.07; 95% CI: 2.50–6.34), racialized nonimmigrants (OR: 2.68; 95% CI: 1.31–5.51) and White immigrants (OR: 2.68; 95% CI: 1.43–5.05) were more likely not to have a potential LD identified. Conclusion: Both racialized and immigrant status are associated with less readiness to pursue LDKT. Supporting patients to communicate their need for LDKT may improve equitable access to LDKT.
KW - immigrant
KW - live donor kidney transplant
KW - transplant
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U2 - 10.1016/j.ekir.2024.01.044
DO - 10.1016/j.ekir.2024.01.044
M3 - Article
AN - SCOPUS:85186586495
SN - 2468-0249
VL - 9
SP - 960
EP - 972
JO - Kidney International Reports
JF - Kidney International Reports
IS - 4
ER -