Health Disparities in Kidney Transplantation: An Equity Analysis

The growing incidence of end stage renal disease along with advances of the past 40 years that have improved the success rate of kidney transplantation have created an unprecedented demand for kidney transplant. Yet, certain racial and ethnic groups and women consistently have longer waiting times and lower rates of transplantation which makes a review of the kidney procurement and transplantation system in view of its equity imperative. Reasons given for these disparities have varied from cultural attitudes and beliefs on the part of patients and health care providers, socioeconomic status, rates of organ donation, and geographic location. The equity conceptual framework has proven itself to be a useful guide in identifying the symptoms of disparities in the procurement and organ allocation system but further studies are needed to identify the etiology of these disparities and target e"ective interventions and policies.