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Literature Review-Clinical: Disparities in Access to Renal Transplantation for African Americans

University of Alabama at Birmingham

Robert S. Gaston

University of Alabama at Birmingham

Background. Minority populations, especially African Americans (AA), are disproportionately affected by deficiencies in our health care system. Because all Americans with end stage renal disease (ESRD) are eligible for government-funded care, one might expect ethnic discrepancies among patients with chronic kidney failure to be minimal. However, AA have long been noted to be at a significant disadvantage when compared with other ethnic groups. Methods. To assess the impact of evolving trends in the management of ESRD on AA, the authors reviewed published reports that examined the relationship between ethnicity, incidence of chronic renal failure, and access to optimal therapy. Results. The incidence of ESRD in AA is 4 times greater than in Caucasians. African Americans remain substantially less likely than whites to be referred for, or undergo, renal transplantation, the preferred treatment for chronic renal failure. Comprehensive explanation of these ongoing observations remains elusive. Conclusions. Despite remarkable advances in ESRD management during the last decade, AA in the United States remain significantly disadvantaged. Further evaluation of underlying causes and the development of specific remedies are warranted.

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