Table 2:
| Full Cohort (n=1,055) | Whites (n=788) | African Americans (n=267) | P value | |
|---|---|---|---|---|
| Age | 56.7 ± 13.4 | 57.5 ± 13.6 | 54.2± 12.6 | <0.001 |
| Female | 405 (38.4) | 301 (38.2) | 104 (39.0) | 0.827 |
| Education (HS+ or less)44,46 |
495 (46.9) | 358 (45.4) | 137 (51.3) | 0.096 |
| Occupation (≤ lower status occupation) | 542 (51.5) | 374 (47.5) | 168 (63.2) | <0.001 |
| Income (< $25,000) | 485 (48.4) | 313 (41.5) | 172 (69.6) | <0.001 |
| Insurance | <0.001 | |||
| Public | 370 (35.4) | 246 (31.4) | 124 (47.2) | |
| Private | 277 (26.5) | 223 (28.5) | 54 (20.5) | |
| Both public/private | 399 (38.2) | 314 (40.1) | 85 (32.3) | |
| Married | 543 (51.5) | 456 (57.9) | 87 (32.6) | <0.001 |
| Medical factors | ||||
| Body Mass Index at evaluation | 29.6 ± 6.3 | 29.6 ± 6.2 | 29.5 ± 6.5 | 0.413 |
| Charlson co-morbidity score | 4.2 ± 1.8 | 4.1 ± 1.7 | 4.4 ± 1.9 | 0.020 |
| Burden of Kidney Disease | 3.6 ± 1.1 | 3.7 ± 1.1 | 3.6 ± 1.1 | 0.399 |
| Number of potential donors | 22.7 ± 17.8 | 21.6 ± 16.5 | 26.2 ± 20.9 | 0.004 |
| Living Donor | 556 (52.8) | 423 (53.8) | 133 (50.0) | 0.290 |
| Duration of dialysis | <.0001 | |||
| 0 years on dialysis | 365 (34.6) | 312 (39.6) | 53 (19.9) | |
| <1 year on dialysis | 470 (44.5) | 346 (43.9) | 124 (46.4) | |
| 1 - ≤5 years on dialysis | 163 (15.5) | 101 (12.8) | 62 (23.2) | |
| >5 years on dialysis | 57 (5.4) | 29 (3.7) | 28 (10.5) | |
| Cultural factors | ||||
| Racism in healthcare | 2.3 ± 0.7 | 2.2 ± 0.7 | 2.7 ± 0.8 | <0.001 |
| Medical mistrust | 2.4 ± 0.5 | 2.4 ± 0.5 | 2.6 ± 0.5 | <0.001 |
| Trust in physician | 2.2 ± 0.5 | 2.2 ± 0.5 | 2.3 ± 0.5 | <0.001 |
| Family loyalty | 49.8 ± 9.4 | 49.0 ± 8.7 | 52.3 ± 10.9 | <0.001 |
| Any Religious objection to LDKT+++@ | 679 (65.3) | 491 (63.2) | 188 (71.5) | 0.015 |
| Experienced discrimination in healthcare | 268 (25.6) | 133 (17.0) | 135 (51.1) | <0.001 |
| Psychosocial factors | ||||
| Social support – Total | 42.4 ± 5.9 | 42.8 ± 5.5 | 41.3 ± 6.7 | 0.007 |
| Self-esteem | 3.2 ± 0.5 | 3.2 ± 0.5 | 3.2 ± 0.5 | 0.277 |
| Internal locus of control | 4.0 ± 1.1 | 3.9 ± 1.1 | 4.1 ± 1.1 | 0.012 |
| External locus of control | 3.4 ± 0.8 | 3.4 ± 0.8 | 3.7 ± 0.9 | <0.001 |
| Anxiety (≥moderate)* | 47 (4.5) | 34 (4.3) | 13 (4.9) | 0.704 |
| Depression (≥moderate)* | 42 (4.0) | 27 (3.4) | 15 (5.6) | 0.113 |
| Transplant knowledge | ||||
| Transplant knowledge | 21.3 ± 2.8 | 21.6 ± 2.7 | 20.2 ± 3.0 | <0.001 |
| Number of learning activities | 4.5 ± 1.6 | 4.6 ± 1.6 | 4.3 ± 1.6 | 0.002 |
| Hours engaged in learning activities | 19.0 ± 23.9 | 20.2 ± 24.1 | 15.4 ± 22.7 | <0.001 |
| Total transplant concerns | 10.9 ± 4.7 | 10.8 ± 4.6 | 11.2 ± 4.9 | 0.258 |
| Outcomes | ||||
| Wait-listed after KAS++ | 29 (4.9) | 16 (3.4) | 13 (11.3) | <0.001 |
| Outcome status | <0.001 | |||
| Wait-listed | 591 (56.0) | 476 (60.4) | 115 (43.1) | |
| Deceased prior to waitlist | 287 (27.2) | 203 (25.8) | 84 (31.5) | |
| Closed patient choice prior to wait-list | 13 (1.2) | 10 (1.3) | 3 (1.1) | |
| Closed due to incomplete evaluation | 116 (11.0) | 64 (8.1) | 52 (19.5) | |
| Clinic rejected prior to wait-list | 26 (2.5) | 18 (2.3) | 8 (3.0) | |
| Still undergoing evaluation | 6 (0.6) | 3 (0.4) | 3 (1.1) | |
| Transplanted at another center | 16 (1.5) | 14 (1.8) | 2 (0.8) |
Patients were recruited after beginning transplant evaluation, 3/10–10/12, and followed through the end of study period, 8/18; Among eligible patients, those enrolled showed no large or significant differences from those not enrolled on any available demographic characteristic (age, sex, race/ethnicity).
Continuous variables were assessed using the Wilcoxon rank sum test and are expressed as mean ± SD while categorical variables were assessed using the Chi-square tests and are expressed as n (%)
HS = High school
KAS = Kidney allocation system
LDKT = Live donor kidney transplantation
Anxiety & depression were measured using the Brief Symptom Inventory (BSI) [Scale 1–5 with >3 being moderate)
Among patients wait-listed (n=591). Remaining n=464 were neither wait-listed active nor wait-listed inactive.
Includes mixed objection (Combination of Neutral and No Objection)
n=2 missing for occupation, transplant knowledge, having living donor; n=3 missing for transplant concerns; n=4 missing for family loyalty score; n=5 missing in medical mistrust index, trust in physician; n=6 missing in total social support; n=7 missing for internal and external locus of control, experienced discrimination in healthcare; n=8 missing for income (45 don’t know/refused), self-esteem scale, total hours engaged in learning activities, n=9 missing for insurance type; n=11 missing for racism in healthcare; n=15 missing for religious objection to LDKT.