ArticleClinical transplantation2024
Dietary Restriction, Socioeconomic Factors, Access to Kidney Transplantation, and Waitlist Mortality.
Emily A Johnston, Jingyao Hong, Akanksha Nalatwad, Yiting Li, Byoungjun Kim, Jane J Long, Nicole M Ali, Barbara Krawczuk, Aarti Mathur, Babak J Orandi and 3 more
Abstract readMulticenter Study
In one paragraphArticle in Clinical transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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What it found
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2 · The registryThe trial behind it
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3 · Its place in the literatureWho cites it
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4 · The recordCorrections and comments
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5 · Who and what moneyAuthors and funding
13 authors.
Emily A JohnstonDepartment of Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York, USA.ORCID 0000-0003-0389-6626 Jingyao HongDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.ORCID 0000-0002-8156-1306 Akanksha NalatwadDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Yiting LiDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.ORCID 0000-0001-6279-5740 Byoungjun KimDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Jane J LongDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Nicole M AliDepartment of Population Health, New York University Grossman School of Medicine, New York, New York, USA.ORCID 0000-0003-1209-2873 Barbara KrawczukDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Aarti MathurDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Babak J OrandiDepartment of Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York, USA.
Joshua ChodoshDepartment of Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York, USA.
Dorry L SegevDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
Mara A McAdams-DeMarcoDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.ORCID 0000-0003-3013-925X Funding
Research Education ComponentP30AG066512 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI REBECCA A. BETENSKY · 2020 to 2026
$28.4MStructural Racism, Resilience, and Premature Cognitive Aging in End-Stage Renal Disease - Revision - 5R01AG077888 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mara A. McAdams DeMarco · 2022 to 2026
$4.4MKidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2MHemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9MCognitive Decline and Incident Dementia in Older Patients with Secondary HyperparathyroidismR01AG076834 · NIA · JOHNS HOPKINS UNIVERSITY · PI Aarti Mathur · 2023 to 2026
$3.3MDeveloping personalized immunosuppression for older kidney transplant recipientsR01DK120518 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2019 to 2022
$2.7MPatient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956kImpact of climate change on cognitive and physical aging of older kidney transplant recipientsK02AG076883 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mara A. McAdams DeMarco · 2023 to 2026
$728kNeighborhood Characteristics and Chronic Kidney Disease Incidence/Progression: A Quasi-Experimental StudyK01DK139420 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Byoungjun Kim · 2024 to 2026
$467kPredicting post-kidney transplant dementia/Alzheimer's Disease risk in older patientsF32AG082486 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI LONG, JANE J · 2023 to 2025
$281kNational Institute of Allergy and Infectious Diseases K24AI144954NIAID NIH HHS K24 AI144954NIA NIH HHS F32 AG082486NIA NIH HHS F32AG082486NIA NIH HHS K02 AG076883NIA NIH HHS K02AG076883NIA NIH HHS P30 AG066512NIA NIH HHS R01 AG055781NIA NIH HHS R01AG055781NIA NIH HHS R01 AG076834NIA NIH HHS R01AG076834NIA NIH HHS R01 AG077888NIA NIH HHS R01AG077888NIDDK NIH HHS K01 DK139420NIDDK NIH HHS R01 DK114074NIDDK NIH HHS R01DK114074NIDDK NIH HHS R01 DK120518NIDDK NIH HHS R01DK120518
6 · The paper itselfAbstract
introductionDietary restrictions for patients with end-stage kidney disease (ESKD) are burdensome. Kidney transplantation (KT) candidates who lack neighborhood resources and are burdened by dietary restrictions may have decreased access to KT.
methodsIn our two-center prospective cohort study (2014-2023), 2471 ESKD patients who were evaluated for KT (candidates) reported their perceived burden of dietary restrictions (not at all, somewhat/moderately, or extremely bothered). Neighborhood-level socioeconomic factors were derived from residential ZIP codes. We quantified the association of perceived burden of the dietary restrictions with a chance of listing using Cox models and risk of waitlist mortality using competing risks models. Then we tested whether these associations differed by neighborhood-level socioeconomic factors.
resultsAt evaluation, 18% of KT candidates felt extremely bothered by dietary restrictions. Those who felt extremely bothered were less likely to be listed for KT (adjusted hazard ratio [aHR] = 0.75, 95% confidence interval [CI]: 0.64-0.87); this association did not differ by neighborhood-level socioeconomic factors. Overall, the burden of dietary restrictions was not associated with waitlist mortality (p = 0.62). However, among candidates living in high food insecurity neighborhoods, those who felt extremely bothered had higher waitlist mortality (adjusted subhazard ratio [aSHR] = 2.07, 95% CI: 1.14-3.75, p
conclusionThe perceived burden of dietary restrictions is associated with a lower chance of listing for KT, and higher waitlist mortality only among candidates residing in neighborhoods with high food insecurity. Transplant centers should identify vulnerable patients and support them with nutrition education and access to food assistance programs.
Indexed as
Kidney Failure, ChronicKidney TransplantationSocioeconomic FactorsWaiting ListsAdultFemaleFollow-Up StudiesFood InsecurityHealth Services AccessibilityHumansMaleMiddle AgedPrognosisProspective StudiesRisk FactorsSurvival Ratedietfood accesskidney transplantNDIquality of lifesocioeconomic status
Identifiers
PMID39427298
PMCPMC11715261
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