Impact of Advancing American Kidney Health on Access to Kidney Transplant

Authors

Luis Ng Sueng, Henry Ford Health
Nawal Peracha, Henry Ford Health
Andrew Wu, Henry Ford HealthFollow
Nadeen J. Khoury, Henry Ford HealthFollow
Milagros D. Samaniego-Picota, Henry Ford HealthFollow
Michelle Jesse, Henry Ford HealthFollow
Pritika Shrivastava, Henry Ford HealthFollow

Recommended Citation

Ng Sueng L, Peracha N, Wu A, Khoury NJ, Samaniego-Picota MD, Jesse M, Shrivastava P. Impact of Advancing American Kidney Health on Access to Kidney Transplant. Journal of the American Society of Nephrology 2022; 33:257.

Document Type

Conference Proceeding

Publication Date

11-1-2022

Publication Title

Journal of the American Society of Nephrology

Abstract

Background: In July 2019, the US Federal Government launched the executive order (EO) Advancing American Kidney Health (AAKH). The focus of this EO was to reduce kidney failure rates and increase rates of kidney transplant. Herein, we explore the impact of the EO on referral (REF), evaluation (EVAL), waitlist (WL), and kidney transplants (T) across racial groups before and after the signing of AAKH. Methods: Retrospective chart review of all patients referred for kidney transplant evaluation at a large, urban healthcare system in Detroit, MI. To ensure equal pre-post timeframes, data collected from all patients referred within 30 months pre- (1/1/2017- 6/30/2019) and post-EO (10/1/2019-3/31/2022). Patients referred in the three months immediate post-EO (7/1/2019-9/30/2019) were excluded to account for system-level adjustment to the EO. Data extracted via existing internal systems included patient race/ ethnicity, gender, frequency and dates of events (i.e., REF, EVAL, WL, and T). An event was coded each time a patient was referred for possible evaluation and categorized as the furthest step achieved (i.e., REF, EVAL, WL, T). Results: A total of 4949 unique patients were identified, though 673 patients had more than one event. Patients were predominantly male (60.4%) and Black (50.8%), followed by White (37.4%) and Other (11.7%). There were significantly greater increases in referrals and evaluations for Black patients compared to White and Other racial categories. Since local average wait time for kidney transplant is >30 months, EO impact on transplant may be too early to assess. WL and T was equitable across groups. Table 1 reports on frequency of events across racial groups pre- to post-EO. Conclusions: Since the passage of EO, minority populations may have better access to kidney transplant, as noted by increase in referrals and evaluation. (Table Presented).

Volume

33

First Page

257