Young aboriginals are less likely to receive a renal transplant: a Canadian national study

Promislow, Steven; Hemmelgarn, Brenda; Rigatto, Claudio; Tangri, Navdeep; Komenda, Paul; Storsley, Leroy; Yeates, Karen; Mojica, Julie; Sood, Manish M

Young aboriginals are less likely to receive a renal transplant: a Canadian national study

dc.contributor.author	Promislow, Steven
dc.contributor.author	Hemmelgarn, Brenda
dc.contributor.author	Rigatto, Claudio
dc.contributor.author	Tangri, Navdeep
dc.contributor.author	Komenda, Paul
dc.contributor.author	Storsley, Leroy
dc.contributor.author	Yeates, Karen
dc.contributor.author	Mojica, Julie
dc.contributor.author	Sood, Manish M
dc.date.accessioned	2013-01-29T12:07:55Z
dc.date.available	2013-01-29T12:07:55Z
dc.date.issued	2013-01-14
dc.date.updated	2013-01-29T12:07:56Z
dc.description.abstract	Abstract Background Previous studies have demonstrated Aboriginals are less likely to receive a renal transplant in comparison to Caucasians however whether this applies to the entire population or specific subsets remains unclear. We examined the effect of age on renal transplantation in Aboriginals. Methods Data on 30,688 dialysis (Aboriginal 2,361, Caucasian 28, 327) patients obtained between Jan. 2000 and Dec. 2009 were included in the final analysis. Racial status was self-reported. Cox proportional hazards, the Fine and Grey sub-distribution method and Poisson regression were used to determine the association between race, age and transplantation. Results In comparison to Caucasians, Aboriginals were less likely to receive a renal transplant (Adjusted HR 0.66 95% CI 0.57-0.77, P < 0.0001) however after stratification by age and treating death as a competing outcome, the effect was more predominant in younger Aboriginals (Age 18–40: 20.6% aboriginals vs. 48.3% Caucasians transplanted; aHR 0.50(0.39-0.61), p < 0.0001, Age 41–50: 10.2% aboriginals vs. 33.9% Caucasians transplanted; aHR 0.46(0.32-0.64), p = 0.005, Age 51–60: 8.2% aboriginals vs. 19.5% Caucasians transplanted; aHR0.65(0.49-0.88), p = 0.01, Age >60: 2.7% aboriginals vs. 2.6% Caucasians transplanted; aHR 1.21(0.76-1.91), P = 0.4, Age X race interaction p < 0.0001). Both living and deceased donor transplants were lower in Aboriginals under the age of 60 compared to Caucasians. Conclusion Younger Aboriginals are less likely to receive a renal transplant compared to their Caucasian counterparts, even after adjustment for comorbidity. Determination of the reasons behind these discrepancies and interventions specifically targeting the Aboriginal population are warranted.
dc.description.version	Peer Reviewed
dc.identifier.citation	BMC Nephrology. 2013 Jan 14;14(1):11
dc.identifier.doi	http://dx.doi.org/10.1186/1471-2369-14-11
dc.identifier.uri	http://hdl.handle.net/1993/15797
dc.language.rfc3066	en
dc.rights	open access	en_US
dc.rights.holder	Steven Promislow et al.; licensee BioMed Central Ltd.
dc.title	Young aboriginals are less likely to receive a renal transplant: a Canadian national study
dc.type	Journal Article