Table 3.
Models for race ethnicity and time from dialysis initiation to deceased donor transplantation among persons 18 to 64 years of age initiating dialysis during 1995 to 2006
| Race Ethnicity |
||||||
|---|---|---|---|---|---|---|
| White (n = 214,229) | Black (n = 182,429) | Asian (n = 11,990) | Hispanic (n = 78,449) | Pacific Islander (n = 5,292) | American Indian/Alaska Native (n = 6,982) | |
| Unadjusted model | ||||||
| hazard ratio (95% CI) | Referent | 0.46 (0.45, 0.47) | 1.04 (0.99, 1.08) | 0.56 (0.54, 0.57) | 0.54 (0.47, 0.62) | 0.39 (0.35, 0.43) |
| Race ethnicity effect attributed to adjustment for clinical factors | ||||||
| percent (95% CI) | — | 0.2 (−0.2, 0.7) | −9.8 (−10.9, −8.8) | −2.1 (−2.7, −1.4) | −0.6 (−2.1, 0.9) | 7.1 (5.4, 8.8) |
| Race-ethnicity effect attributed to adjustment for health insurance coverage and zip code poverty | ||||||
| percent (95% CI) | — | 17.9 (17.0, 18.8) | −3.7 (−4.5, −2.9) | 14.3 (13.4, 15.1) | −5.0 (−6.3, −3.6) | 23.2 (21.3, 25.2) |
| Race ethnicity effect attributed to adjustment for household linguistic isolation | ||||||
| percent (95% CI) | — | 0.5 (0.2, 0.8) | 5.7 (4.8, 6.5) | 7.0 (6.0, 8.0) | 6.2 (5.3, 7.1) | −1.0 (−1.3, −0.6) |
| Race ethnicity effect attributed to adjustment for regional (OPO) organ availability | ||||||
| percent (95% CI) | — | 2.6 (2.1, 3.0) | 1.1 (0.5, 1.7) | 13.5 (12.7, 14.3) | 19.1 (16.1, 22.1) | 0.5 (−0.5, 1.6) |
| Percentage of the race ethnicity effect explained by adjustment for all measured factors | ||||||
| percent (95% CI) | — | 13.7 (12.4, 15.0) | −8.7 (−10.8, −6.7) | 37.6 (35.1, 40.1) | 28.2 (24.0, 32.3) | 42.8 (38.7, 47.0) |
| Fully adjusted modela (residual difference after covariate adjustment) | ||||||
| hazard ratio (95% CI) | Referent | 0.52 (0.51, 0.53) | 0.95 (0.91, 0.99) | 0.72 (0.70, 0.74) | 0.63 (0.58, 0.70) | 0.56 (0.51, 0.61) |
Negative values indicate that, after adjustment for the specific factors, differences in time to transplant compared with whites were larger than observed in the unadjusted model.
aFully adjusted model includes age, gender, health insurance coverage (employer group insurance, Medicare, Medicaid, other insurance, or no insurance), clinical factors (cardiovascular disease, diabetes [insulin or non-insulin requiring], poor functional status [institutionalized, requires assistance with daily activities, inability to walk, inability to transfer], cancer, drug or tobacco use, hypoalbumemia [serum albumin < 3.5 g/dl], low hemoglobin [<10 g/dl], prescribed predialysis erythropoiesis-stimulating agent, and body mass [body mass index <18.5, 18.5 to 24.9, 25.0 to 29.9, ≥30.0 kg/m2]), UNOS/OPO region, zip code poverty (<5, 5 to 9, 10 to 14, 15 to 19, ≥20%), and household linguistic isolation (<1, 1 to 4, 5 to 10, 10 to 19, ≥20%).