National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedKrissberg JR, Kaufmann MB, Gupta A
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
This study aimed to assess how implementation of the 2014 Kidney Allocation System (KAS) affected racial and ethnic disparities in pediatric kidney transplantation access and related outcomes. The authors performed a retrospective cohort study of children <18 years of age active on the kidney transplant list from 2008 to 2019 using the Scientific Registry of Transplant Recipients. Results found that all children experienced longer wait times from activation to transplantation post-KAS. Although they found that Black and Hispanic children and other children of color experienced longer times from activation to transplant compared with White children in both eras; this finding was largely attenuated after multivariable analysis. Multivariable analysis also showed that racial and ethnic disparities in time from dialysis initiation to transplantation in the pre-KAS era were lessened in the post-KAS era. No disparities were found in odds of delayed graft function, however Black and Hispanic children experienced longer times with a functioning graft in the post-KAS era.
AHRQ-funded; HS026128.
Citation: Krissberg JR, Kaufmann MB, Gupta A .
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
Clin J Am Soc Nephrol 2021 Dec; 16(12):1862-71. doi: 10.2215/cjn.06740521..
Keywords: Disparities, Racial and Ethnic Minorities, Kidney Disease and Health, Transplantation
Nguyen KH, Thorsness R, Hayes S
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
This study examined the impact of COVID-19 on initiation of kidney failure treatment during the first 4 months of the pandemic with a focus on racial, ethnic, and socioeconomic disparities. The study population included 127,149 patients with incident kidney failure between January 2018 and June 2020. The mean age of patients was 62.8 years, and were 41.7% female, 25.9% non-Hispanic Black and 15.6% Hispanic/Latino. There were significant decreases in the proportion of patients with incident kidney failure receiving preemptive transplantation and initiating hemodialysis treatment with an arteriovenous fistula during the first 4 months of the pandemic compared to the pre-COVID-19 period. These decreases were most significant among non-Hispanic Black patients. There were also significant decreases in patients residing in counties in the highest quintile of COVID-19 mortality rates, but not for patients residing in other counties. Treatment initiation was approximately 30% lower than projected in April 2020.
AHRQ-funded; HS028285.
Citation: Nguyen KH, Thorsness R, Hayes S .
Evaluation of racial, ethnic, and socioeconomic disparities in initiation of kidney failure treatment during the first 4 months of the COVID-19 pandemic.
JAMA Netw Open 2021 Oct;4(10):e2127369. doi: 10.1001/jamanetworkopen.2021.27369..
Keywords: COVID-19, Kidney Disease and Health, Racial and Ethnic Minorities, Disparities
Akwo EA, Robinson-Cohen C, Chung CP
Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program.
Apparent treatment-resistant hypertension (ATRH) has been linked to end-stage kidney disease (ESKD) and cardiovascular disease. In this study, the investigators tested the hypothesis that the effect of ATRH on ESKD is greater in Black patients than in White patients and investigated the effect of ATRH on ESKD independent of APOL1 genotype. The investigators concluded that ATRH was associated with an elevated risk of adverse kidney and cardiovascular outcomes. The effect of ATRH on incident ESKD was magnified among patients with reduced kidney function as well as Black patients, independently of APOL1 genotype.
AHRQ-funded; HS026395.
Citation: Akwo EA, Robinson-Cohen C, Chung CP .
Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program.
Hypertension 2021 Aug;78(2):376-86. doi: 10.1161/hypertensionaha.120.16181..
Keywords: Blood Pressure, Kidney Disease and Health, Racial and Ethnic Minorities
Kim D, Lee Y, Thorsness R
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.
AHRQ-funded; HS028285.
Citation: Kim D, Lee Y, Thorsness R .
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health