ArticlePloS one2021
Patient and allograft outcomes after kidney transplant for the Indigenous patients in the United States.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- A Single-Center Report of Hypertension in Native American Kidney Transplant Recipients.Journal of immigrant and minority health · 2025Observational
- Impact of Medicaid expansion on kidney transplantation in the State Oklahoma.World journal of transplantation · 2024Article
- Post-operative outcomes in Indigenous patients in North America and Oceania: A systematic review and meta-analysis.PLOS global public health · 2023Article
- Identifying Drivers of Poor Kidney Transplant Outcomes in Indigenous Populations.Kidney international reports · 2022Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objective is to assess cardiovascular (CV), malignancy, infectious, graft outcomes and tacrolimus levels for the Indigenous patients compared to Whites after kidney transplant (KTx).
methods165 Indigenous and 165 White patients matched for the KTx year at Mayo Clinic Arizona from 2007-2015 were studied over a median follow-up of 3 years. Propensity score was calculated to account for baseline differences.
resultsCompared to Whites, Indigenous patients had the following characteristics: younger age, more obesity, diabetes, hypertension, and required dialysis prior to KTx (p<0.01). Indigenous patients had longer hospital stay for KTx, shorter follow-up and lived further from the transplant center (p<0.05). 210 (63.6%) received deceased donor KTx and more Whites received a living donor KTx compared to Indigenous patients (55.2% vs 17.6%, p<0.0001). Post-KTx, there was no difference in the CV event rates. The cumulative incidence of infectious complications was higher among the Indigenous patients (HR 1.81, p = 0.0005, 48.5% vs 38.2%, p = 0.013), with urinary causes as the most common. Malignancy rates were increased among Whites (13.3% vs 3.0%, p = 0.001) with skin cancer being the most common. There was a significant increase in the dose normalized tacrolimus level for the Indigenous patients compared to Whites at 1 months, 3 months, and 1 year post-KTx. After adjustment for the propensity score, there was no statistical difference in infectious or graft outcomes between the two groups but the mean number of emergency room visits and hospitalizations after KTx was significantly higher for Whites compared to Indigenous patients.
conclusionsCompared to Whites, Indigenous patients have similar CV events, graft outcomes and infectious complications after accounting for baseline differences.
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