Barriers to Kidney Transplantation among Hispanics in Laredo, Texas

Kidney Week 2020

Hispanics are the largest minority group in the United States. Compared with non-Hispanic Whites, Hispanics are more likely to develop end-stage renal disease (ESRD), yet are less likely to receive a deceased-donor kidney transplant. To examine barriers to transplantation among Hispanic Patients with ESKD, Armando T. Cardenas, MD, and colleagues at the University of the Incarnate Word, San Antonio, Texas, conducted an analysis of data from clinics on the Mexican-American border.

Results of the analysis were reported during a virtual poster session at ASN Kidney Week 2020. The poster was titled Patient Barriers to Kidney Transplantation on the Mexican American Border.

Data were collected from three dialysis clinics in Laredo, Texas. Laredo has a population of ~250,000, 95.6% of whom are Hispanic. The researchers determined the number of patients waitlisted or scheduled for living-donor transplantation as well as the number of patients who were referred but not listed and those who were not referred at all. Reasons for nonreferral were also investigated.

The analysis included 285 patients. Of those, 18.2% (n=52) were waitlisted or scheduled for living-donor transplantation, 31.9% (n=91) were referred but not yet waitlisted or scheduled for living-donor transplantation, and 49.1% (n=140) were not referred.

Among the 140 patients not referred for evaluation for transplantation, the most common reasons were advanced age (25%), weight (4.2%), malignancy (2.85%), cardiovascular complications (4.2%), peripheral vascular disease (3.57%), functional status (5.71%), noncompliance (5.71%), transportation issues (10.71%), and immigration status (7.14%).

In conclusion, the researchers said, “Nearly half of ESRD patients were not referred for transplant evaluation and less than half of those referred were waitlisted or scheduled for living-donor transplantation. This is lower than previous studies showing a greater percentage of referred patients as waitlisted (up to 66% in some studies). Major barriers to referral included age, immigration status, and transportation limitations. The latter two barriers are likely more a factor in a Mexican-American border town than in other areas of the United States. Identifying these barriers highlight areas for improvement in access to renal transplantation for Hispanics.”

Source: Cardenas AT, Georffino JPZ, Mcnutt G. Patient barriers to kidney transplantation on the Mexican American border. Abstract of a poster presented at the American Society of Nephrology virtual Kidney Week 2020 (PO2494), October 22, 2020.