Race, relationship and renal diagnoses after living kidney donation

Krista L. Lentine, Mark A. Schnitzler, Amit X. Garg, Huiling Xiao, David Axelrod, Janet E. Tuttle-Newhall, Daniel Brennan, Dorry Segev

Research output: Contribution to journalArticle

Abstract

Background. In response to recent studies, a better understanding of the risks of renal complications among African American and biologically related living kidney donors is needed. Methods. We examined a database linking U.S. registry identifiers for living kidney donors (1987-2007) to billing claims from a private health insurer (2000-2007 claims) to identify renal condition diagnoses categorized by International Classification of Diseases 9th Revision coding. Cox regression with left and right censoring was used to estimate cumulative incidence of diagnoses after donation and associations (adjusted hazards ratios, aHR) with donor traits. Results. Among 4650 living donors, 13.1% were African American and 76.3% were white; 76.1% were firstdegree relatives of their recipient. By 7 years post-donation, after adjustment for age and sex, greater proportions of African American compared with white donors had renal condition diagnoses: chronic kidney disease (12.6% vs 5.6%; aHR, 2.32; 95% confidence interval [95% CI], 1.48-3.62), proteinuria (5.7% vs 2.6%; aHR, 2.27; 95% CI, 1.32-3.89), nephrotic syndrome (1.3% vs 0.1%; aHR, 15.7; 95% CI, 2.97-83.0), and any renal condition (14.9% vs 9.0%; aHR, 1.72; 95% CI, 1.23-2.41). Although first-degree biological relationship to the recipient was not associated with renal risk, associations of African American race persisted for these conditions and included unspecified renal failure and reported disorders of kidney dysfunction after adjustment for biological donor-recipient relationship. Conclusions. African Americans more commonly develop renal conditions after living kidney donation, independent of donor-recipient relationship. Continued research is needed to improve risk stratification for renal outcomes among African American living donors.

Original languageEnglish (US)
Pages (from-to)1723-1729
Number of pages7
JournalTransplantation
Volume99
Issue number8
DOIs
StatePublished - Aug 1 2015

Fingerprint

Kidney
African Americans
Living Donors
Tissue Donors
Confidence Intervals
Insurance Carriers
Social Conditions
Nephrotic Syndrome
International Classification of Diseases
Chronic Renal Insufficiency
Proteinuria
Renal Insufficiency
Registries
Databases
Incidence
Health
Research

ASJC Scopus subject areas

  • Transplantation

Cite this

Lentine, K. L., Schnitzler, M. A., Garg, A. X., Xiao, H., Axelrod, D., Tuttle-Newhall, J. E., ... Segev, D. (2015). Race, relationship and renal diagnoses after living kidney donation. Transplantation, 99(8), 1723-1729. https://doi.org/10.1097/TP.0000000000000733

Race, relationship and renal diagnoses after living kidney donation. / Lentine, Krista L.; Schnitzler, Mark A.; Garg, Amit X.; Xiao, Huiling; Axelrod, David; Tuttle-Newhall, Janet E.; Brennan, Daniel; Segev, Dorry.

In: Transplantation, Vol. 99, No. 8, 01.08.2015, p. 1723-1729.

Research output: Contribution to journalArticle

Lentine, KL, Schnitzler, MA, Garg, AX, Xiao, H, Axelrod, D, Tuttle-Newhall, JE, Brennan, D & Segev, D 2015, 'Race, relationship and renal diagnoses after living kidney donation', Transplantation, vol. 99, no. 8, pp. 1723-1729. https://doi.org/10.1097/TP.0000000000000733
Lentine KL, Schnitzler MA, Garg AX, Xiao H, Axelrod D, Tuttle-Newhall JE et al. Race, relationship and renal diagnoses after living kidney donation. Transplantation. 2015 Aug 1;99(8):1723-1729. https://doi.org/10.1097/TP.0000000000000733
Lentine, Krista L. ; Schnitzler, Mark A. ; Garg, Amit X. ; Xiao, Huiling ; Axelrod, David ; Tuttle-Newhall, Janet E. ; Brennan, Daniel ; Segev, Dorry. / Race, relationship and renal diagnoses after living kidney donation. In: Transplantation. 2015 ; Vol. 99, No. 8. pp. 1723-1729.
@article{fee7eeff32164b7abcb0186acadf109d,
title = "Race, relationship and renal diagnoses after living kidney donation",
abstract = "Background. In response to recent studies, a better understanding of the risks of renal complications among African American and biologically related living kidney donors is needed. Methods. We examined a database linking U.S. registry identifiers for living kidney donors (1987-2007) to billing claims from a private health insurer (2000-2007 claims) to identify renal condition diagnoses categorized by International Classification of Diseases 9th Revision coding. Cox regression with left and right censoring was used to estimate cumulative incidence of diagnoses after donation and associations (adjusted hazards ratios, aHR) with donor traits. Results. Among 4650 living donors, 13.1{\%} were African American and 76.3{\%} were white; 76.1{\%} were firstdegree relatives of their recipient. By 7 years post-donation, after adjustment for age and sex, greater proportions of African American compared with white donors had renal condition diagnoses: chronic kidney disease (12.6{\%} vs 5.6{\%}; aHR, 2.32; 95{\%} confidence interval [95{\%} CI], 1.48-3.62), proteinuria (5.7{\%} vs 2.6{\%}; aHR, 2.27; 95{\%} CI, 1.32-3.89), nephrotic syndrome (1.3{\%} vs 0.1{\%}; aHR, 15.7; 95{\%} CI, 2.97-83.0), and any renal condition (14.9{\%} vs 9.0{\%}; aHR, 1.72; 95{\%} CI, 1.23-2.41). Although first-degree biological relationship to the recipient was not associated with renal risk, associations of African American race persisted for these conditions and included unspecified renal failure and reported disorders of kidney dysfunction after adjustment for biological donor-recipient relationship. Conclusions. African Americans more commonly develop renal conditions after living kidney donation, independent of donor-recipient relationship. Continued research is needed to improve risk stratification for renal outcomes among African American living donors.",
author = "Lentine, {Krista L.} and Schnitzler, {Mark A.} and Garg, {Amit X.} and Huiling Xiao and David Axelrod and Tuttle-Newhall, {Janet E.} and Daniel Brennan and Dorry Segev",
year = "2015",
month = "8",
day = "1",
doi = "10.1097/TP.0000000000000733",
language = "English (US)",
volume = "99",
pages = "1723--1729",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Race, relationship and renal diagnoses after living kidney donation

AU - Lentine, Krista L.

AU - Schnitzler, Mark A.

AU - Garg, Amit X.

AU - Xiao, Huiling

AU - Axelrod, David

AU - Tuttle-Newhall, Janet E.

AU - Brennan, Daniel

AU - Segev, Dorry

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background. In response to recent studies, a better understanding of the risks of renal complications among African American and biologically related living kidney donors is needed. Methods. We examined a database linking U.S. registry identifiers for living kidney donors (1987-2007) to billing claims from a private health insurer (2000-2007 claims) to identify renal condition diagnoses categorized by International Classification of Diseases 9th Revision coding. Cox regression with left and right censoring was used to estimate cumulative incidence of diagnoses after donation and associations (adjusted hazards ratios, aHR) with donor traits. Results. Among 4650 living donors, 13.1% were African American and 76.3% were white; 76.1% were firstdegree relatives of their recipient. By 7 years post-donation, after adjustment for age and sex, greater proportions of African American compared with white donors had renal condition diagnoses: chronic kidney disease (12.6% vs 5.6%; aHR, 2.32; 95% confidence interval [95% CI], 1.48-3.62), proteinuria (5.7% vs 2.6%; aHR, 2.27; 95% CI, 1.32-3.89), nephrotic syndrome (1.3% vs 0.1%; aHR, 15.7; 95% CI, 2.97-83.0), and any renal condition (14.9% vs 9.0%; aHR, 1.72; 95% CI, 1.23-2.41). Although first-degree biological relationship to the recipient was not associated with renal risk, associations of African American race persisted for these conditions and included unspecified renal failure and reported disorders of kidney dysfunction after adjustment for biological donor-recipient relationship. Conclusions. African Americans more commonly develop renal conditions after living kidney donation, independent of donor-recipient relationship. Continued research is needed to improve risk stratification for renal outcomes among African American living donors.

AB - Background. In response to recent studies, a better understanding of the risks of renal complications among African American and biologically related living kidney donors is needed. Methods. We examined a database linking U.S. registry identifiers for living kidney donors (1987-2007) to billing claims from a private health insurer (2000-2007 claims) to identify renal condition diagnoses categorized by International Classification of Diseases 9th Revision coding. Cox regression with left and right censoring was used to estimate cumulative incidence of diagnoses after donation and associations (adjusted hazards ratios, aHR) with donor traits. Results. Among 4650 living donors, 13.1% were African American and 76.3% were white; 76.1% were firstdegree relatives of their recipient. By 7 years post-donation, after adjustment for age and sex, greater proportions of African American compared with white donors had renal condition diagnoses: chronic kidney disease (12.6% vs 5.6%; aHR, 2.32; 95% confidence interval [95% CI], 1.48-3.62), proteinuria (5.7% vs 2.6%; aHR, 2.27; 95% CI, 1.32-3.89), nephrotic syndrome (1.3% vs 0.1%; aHR, 15.7; 95% CI, 2.97-83.0), and any renal condition (14.9% vs 9.0%; aHR, 1.72; 95% CI, 1.23-2.41). Although first-degree biological relationship to the recipient was not associated with renal risk, associations of African American race persisted for these conditions and included unspecified renal failure and reported disorders of kidney dysfunction after adjustment for biological donor-recipient relationship. Conclusions. African Americans more commonly develop renal conditions after living kidney donation, independent of donor-recipient relationship. Continued research is needed to improve risk stratification for renal outcomes among African American living donors.

UR - http://www.scopus.com/inward/record.url?scp=84929956009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929956009&partnerID=8YFLogxK

U2 - 10.1097/TP.0000000000000733

DO - 10.1097/TP.0000000000000733

M3 - Article

C2 - 25905980

AN - SCOPUS:84929956009

VL - 99

SP - 1723

EP - 1729

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 8

ER -