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Social deprivation, ethnicity, and uptake of living kidney donor transplantation in the United Kingdom

Udayaraj, Udaya, Ben-Shlomo, Yoav, Roderick, Paul, Casula, Anna, Dudley, Chris, Collett, Dave, Ansell, David, Tomson, Charles and Caskey, Fergus (2012) Social deprivation, ethnicity, and uptake of living kidney donor transplantation in the United Kingdom Transplantation, 93, (6), pp. 610-616. (doi:10.1097/TP.0b013e318245593f). (PMID:22245879).

Record type: Article


Background. Socioeconomic disparities and their contribution to the ethnic differences in living kidney donor transplantation have not been adequately studied.

Methods. A total of 12,282 patients aged 18 to 69 years starting renal replacement therapy (January 1, 1997, to December 31, 2004) in the United Kingdom were included. Logistic regression models were used to examine probability of living donor transplantation within 3 years of renal replacement therapy. The effect of area deprivation (Townsend index) was studied among whites only adjusted for patient characteristics and the effect of ethnic origin (South Asians and blacks compared with whites) was then examined among all patients adjusting for area deprivation.

Results. Among whites, increasing social deprivation was associated with lower odds of living donor transplantation. In the fully adjusted model, odds ratio (OR) for the most deprived quintile was 0.40 (95% confidence interval [CI] 0.33, 0.49; P trend<0.0001) compared with the least deprived. These gradients were more pronounced among centers performing more live donor transplants (P value for interaction <0.0001). South Asians and blacks had lower odds of living donor transplantation compared with whites, but there was an interaction with age (P<0.0001), so that this disparity was observed only in those younger than 50 years (blacks: OR, 0.31; 95% CI, 0.18, 0.54; South Asians: OR, 0.55; 95% CI, 0.34, 0.90; P value <0.0001).

Conclusions. Socially deprived and younger ethnic minority patients have lower probability of living kidney donor transplantation. The extent to which these inequalities reflect modifiable societal healthcare system barriers and donor/recipient factors requires further study.

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Published date: 27 March 2012
Organisations: Primary Care & Population Sciences


Local EPrints ID: 335550
ISSN: 0041-1337
PURE UUID: a439998d-1179-4e6a-8892-98e024d2bc6f
ORCID for Paul Roderick: ORCID iD

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Date deposited: 12 Mar 2012 15:13
Last modified: 18 Jul 2017 06:10

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Author: Udaya Udayaraj
Author: Yoav Ben-Shlomo
Author: Paul Roderick ORCID iD
Author: Anna Casula
Author: Chris Dudley
Author: Dave Collett
Author: David Ansell
Author: Charles Tomson
Author: Fergus Caskey

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