Original Clinical Science
Disparities in Completion Rates of the Medical Prerenal Transplant Evaluation by Race or Ethnicity and Gender Rebecca S. Monson,1,2 Patricia Kemerley,1 Douglas Walczak,1 Enrico Benedetti,1 Jose Oberholzer,1 and Kirstie K. Danielson1,2 Background. A significant number of potential kidney transplant candidates do not complete the required medical evaluation after referral to a transplant program. Methods. Factors associated with rate of completion of the renal transplant evaluation were analyzed using a retrospective chart review of patients first seen between October 1, 2009, and September 30, 2010 (n=256). The primary endpoint was completion in 12 months. Independent variables included socioeconomic, demographic, and medical factors. Results. Mean age was 50.7 years; 49.6% were black, 28.5% Hispanic, and 21.9% white and other; 26.3% did not require dialysis. During follow-up, 23.4% did not complete the evaluation. Multivariable analysis indicated that slower rates of completion were associated with needing a greater number of medical tests (compared to 0–2: 3–5 tests, hazard ratio [HR]=0.65, P=0.02; ≥6 tests, HR=0.47, P=0.0005) and requiring more than one hospitalization (compared to none: HR=0.37, P=0.0008). A significant interaction between race or ethnicity and gender on completion was found: compared to black men, Hispanic men (HR=2.75, P0.10). Differences in the rate of completion were found to be associated (P≤0.10) with race or ethnicity (compared to white and other: black hazard ratio [HR] =0.68, P=0.04; Hispanic HR=1.40, P=0.08; overall race or ethnicity, P12 mo Had previous incomplete workup
Value
50.7 109
(12.3) (42.6)
56 127 73 187
(21.9) (49.6) (28.5) (74.8)
96 107 52 41.0
(37.6) (42.0) (20.4) (34.3, 56.5)
109 93 53
(42.7) (36.5) (20.8)
63 96 80 18
(26.3) (40.2) (33.5) (7.0)
Values are mean (standard deviation), median (interquartile range), or n (%). Sample sizes: employed, n=250; primary insurance, n=255; income, n=255; marital status, n=255; time on dialysis, n=239.
needing more than one hospitalization at UIC versus none (HR=0.40, P=0.001; Fig. 1A), and requiring a greater number of tests (compared to 0–2: 3–5 tests HR=0.69, P=0.04; ≥6 tests HR=0.51, P=0.001; Fig. 1B). Needing certain tests was associated with a slower rate of completion: stress test (HR=0.55, P
Disparities in Completion Rates of the Medical Prerenal Transplant Evaluation by Race or Ethnicity and Gender Rebecca S. Monson,1,2 Patricia Kemerley,1 Douglas Walczak,1 Enrico Benedetti,1 Jose Oberholzer,1 and Kirstie K. Danielson1,2 Background. A significant number of potential kidney transplant candidates do not complete the required medical evaluation after referral to a transplant program. Methods. Factors associated with rate of completion of the renal transplant evaluation were analyzed using a retrospective chart review of patients first seen between October 1, 2009, and September 30, 2010 (n=256). The primary endpoint was completion in 12 months. Independent variables included socioeconomic, demographic, and medical factors. Results. Mean age was 50.7 years; 49.6% were black, 28.5% Hispanic, and 21.9% white and other; 26.3% did not require dialysis. During follow-up, 23.4% did not complete the evaluation. Multivariable analysis indicated that slower rates of completion were associated with needing a greater number of medical tests (compared to 0–2: 3–5 tests, hazard ratio [HR]=0.65, P=0.02; ≥6 tests, HR=0.47, P=0.0005) and requiring more than one hospitalization (compared to none: HR=0.37, P=0.0008). A significant interaction between race or ethnicity and gender on completion was found: compared to black men, Hispanic men (HR=2.75, P0.10). Differences in the rate of completion were found to be associated (P≤0.10) with race or ethnicity (compared to white and other: black hazard ratio [HR] =0.68, P=0.04; Hispanic HR=1.40, P=0.08; overall race or ethnicity, P12 mo Had previous incomplete workup
Value
50.7 109
(12.3) (42.6)
56 127 73 187
(21.9) (49.6) (28.5) (74.8)
96 107 52 41.0
(37.6) (42.0) (20.4) (34.3, 56.5)
109 93 53
(42.7) (36.5) (20.8)
63 96 80 18
(26.3) (40.2) (33.5) (7.0)
Values are mean (standard deviation), median (interquartile range), or n (%). Sample sizes: employed, n=250; primary insurance, n=255; income, n=255; marital status, n=255; time on dialysis, n=239.
needing more than one hospitalization at UIC versus none (HR=0.40, P=0.001; Fig. 1A), and requiring a greater number of tests (compared to 0–2: 3–5 tests HR=0.69, P=0.04; ≥6 tests HR=0.51, P=0.001; Fig. 1B). Needing certain tests was associated with a slower rate of completion: stress test (HR=0.55, P
