Article Figures & Data
Figures
- Figure 1.
Odds ratios (ORs) for preemptive transplantation in Black (upper panel) and Hispanic (lower panel) patients with autosomal dominant polycystic kidney disease (ADPKD) compared with White patients. Two networks (Network 6 and Network 8) are omitted from the lower panel because no preemptive transplants occurred in Hispanic patients during the study period. 95% CI, 95 confidence interval; CMS, Centers for Medicare & Medicaid Services; CO, Colorado; IN, Indiana; MN, Minnesota; NC, North Carolina; NJ, New Jersey; VA, Virginia; WA, Washington.
- Figure 2.
Kaplan–Meier failure curve representing the unadjusted probability of receiving a kidney transplant by race and ethnicity among patients with ADPKD who initiated dialysis as a first kidney treatment event.
- Figure 3.
Adjusted hazard ratios (HRs) for transplantation among patients initiating dialysis in Black (upper panel) and Hispanic (lower panel) patients with ADPKD compared with White patients. CO, Colorado; IN, Indiana; MN, Minnesota; NC, North Carolina; NJ, New Jersey; VA, Virginia; WA, Washington.
Tables
- Table 1.
Characteristics of patients with autosomal dominant polycystic kidney disease in the United States Renal Data System survey at the time of a first transplant or dialysis initiation from January 2000 through June 2018
Characteristic All, n=41,485 White, n=32,065 Black, n=5517 Hispanic, n=3903 Age at kidney failure onset, yr (SD) 56 (12) 57 (12) 55 (13) 53 (12) BMI, kg/m2 (SD) 28.0 (6.8) 28.1 (6.8) 27.9 (7.2) 27.7 (6.5) Median household income for zip code area, ×$1000 (SD) 54 (22) 56 (22) 46 (20) 47 (21) eGFR, ml/min per 1.73 m2 (SD) 8.4 (3.9) 8.8 (3.9) 7.0 (3.4) 7.6 (3.7) Hemoglobin, g/dl 10.5 (1.8) 10.7 (1.8) 9.7 (1.9) 10.1 (1.8) Albumin, mg/dl 3.8 (0.6) 3.8 (0.6) 3.6 (0.6) 3.8 (0.6) Women, % 46 46 50 46 Nephrology care before kidney failure, % 90 92 84 81 EPO, % 33 33 34 30 Private insurance, % 68 73 54 52 Employment, % 6 mo prior to kidney failure 45 47 39 42 At onset of kidney failure 37 39 29 31 First kidney failure treatment, n (%) Preemptive transplant 6586 (16) 6009 (19) 266 (5) 311 (8) Hemodialysis 27,787 (67) 20,365 (63) 4445 (80) 2977 (76) Peritoneal dialysis 7112 (17) 5691 (18) 806 (15) 615 (16) Comorbid conditions, % Diabetes 9 9 13 11 Hypertension 89 89 92 89 Congestive heart failure 8 8 12 5 Stroke 4 4 6 4 Cancer 4 4 5 2 All variables are presented as mean (SD) unless otherwise stated. Missing data are <1% for all variables except hemoglobin (12%), albumin (23%), nephrology care (25%), and EPO (17%). BMI, body mass index; EPO, erythropoietin.
- Table 2.
Transplantation outcomes of patients with autosomal dominant polycystic kidney disease by race and ethnicity
Outcome All (n=41485) White (n=32065) Black (n=5517) Hispanic (n=3903) P Value Waitlisted, n (%) 24,768 (60) 19,603 (61) 2783 (50) 2382 (61) <0.001 Waitlisted prior to kidney failure, n (%) 14,171 (34) 12,229 (38) 1090 (20) 852 (22) <0.001 Transplant, all, n (%) 19,953 (48) 16,588 (52) 1728 (31) 1637 (42) <0.001 Preemptive transplant, n (%) 6586 (16) 6009 (19) 266 (5) 311 (8) <0.001 LD transplant, n (%) 9610 (23) 8620 (27) 407 (7) 583 (15) <0.001 Preemptive LD transplant, n (%) 4972 (12) 4579 (14) 158 (3) 235 (6) <0.001 Kidney failure to waiting list, mo, median (IQR) −2 (−11 to 8) −3 (−12 to 6) 5 (−7 to 15) 6 (−5 to 15) <0.001 Waiting list to transplant, mo, median (IQR) 17 (7–34) 15 (6–31) 28 (11–49) 24 (9–48) <0.001 Kidney failure to transplant, mo, median (IQR) 10 (0–32) 7 (0–27) 31 (10–57) 29 (6–57) <0.001 LD, living donor; IQR, interquartile range.
- Table 3.
Preemptive transplantation as the first ESRD service event by race and ethnicity (odds ratios calculated with White patients with autosomal dominant polycystic kidney disease as the reference group)
Variable Unadjusted Adjusted Odds Ratio (95% Confidence Interval) Odds Ratio (95% Confidence Interval) Black 0.22 (0.19 to 0.25) 0.33 (0.29 to 0.38) Hispanic 0.38 (0.33 to 0.42) 0.50 (0.44 to 0.56) Women 1.38 (1.30 to 1.47) Age at kidney failure, per 10 yr 0.80 (0.78 to 0.83) Employment 1.90 (1.77 to 2.04) Private insurance 2.67 (2.43 to 2.93) Nephrology care prior to kidney failure 2.19 (1.91 to 2.52) Albumin (serum), per 1.0 g/dl 1.05 (1.04 to 1.06) Hemoglobin, per 1.0 g/dl 1.20 (1.18 to 1.22) Body mass index, per 1 kg/m2 0.98 (0.98 to 0.99) Median income in zip code, per $10,000, with private insurance 1.14 (1.13 to 1.16) Median income in zip code, per $10,000, all other insurance 1.25 (1.21 to 1.29) - Table 4.
Transplantation after initiation of dialysis by race and ethnicity (odds ratios calculated with White patients with autosomal dominant polycystic kidney disease as the reference group)
Variable Unadjusted Adjusted, Cause Specific Adjusted, Subdistribution Hazards Hazard Ratio (95% Confidence Interval) P Value Hazard Ratio (95% Confidence Interval) P Value Hazard Ratio (95% Confidence Interval) P Value Black 0.52 (0.50 to 0.55) <0.001 0.57 (0.54 to 0.60) <0.001 0.61 (0.58 to 0.64) <0.001 Hispanic 0.69 (0.65 to 0.73) <0.001 0.71 (0.67 to 0.75) <0.001 0.78 (0.74 to 0.83) <0.001 Women 1.01 (0.98 to 1.05) 0.50 1.04 (1.01 to 1.08) 0.02 Age at kidney failure, per 10 yr 0.71 (0.70 to 0.72) <0.001 0.66 (0.65 to 0.67) <0.001 Median income in zip code, per $10,000 1.06 (1.06 to 1.07) <0.001 1.06 (1.06 to 1.07) <0.001 Employment 1.47 (1.41 to 1.53) <0.001 1.58 (1.52 to 1.65) <0.001 Private insurance 2.09 (2.01 to 2.19) <0.001 2.15 (2.05 to 2.25) <0.001 Nephrology care prior to kidney failure 1.37 (1.28 to 1.46) <0.001 1.34 (1.25 to 1.44) <0.001 Albumin (serum), per 1.0 g/dl 1.01 (1.01 to 1.02) <0.001 1.02 (1.02 to 1.03) <0.001 Hemoglobin, per 1.0 g/dl 1.02 (1.00 to 1.03) 0.005 1.02 (1.01 to 1.03) 0.002 Body mass index, per 1 kg/m2 0.98 (0.98 to 0.98) <0.001 0.98 (0.98 to 0.98) <0.001
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