BACKGROUND: Racial and ethnic disparities among North American patients with chronic kidney disease have received significant attention. In contrast, little is known about health-related outcomes of patients with end-stage renal disease among the Roma minority, also known as gypsies, compared to Caucasian individuals. We prospectively assessed the association between Roma ethnicity and long-term clinical outcomes in kidney transplant recipients. METHODS: In a prevalent cohort of renal transplant recipients, followed up over a median of 94 months, we prospectively collected socio-demographic, medical (and transplant related) characteristics and laboratory data at baseline from 60 Roma and 1,003 Caucasian patients (mean age 45 (SD = 11) and 49 (SD = 13) years, 33 and 41% women, 18 and 17% with diabetes mellitus, respectively). Survival analyses examined the associations between Roma ethnicity and all-cause mortality and death-censored graft loss or death with functioning renal allograft. RESULTS: During the follow-up period, 341 patients (32%) died. Two-hundred eighty (26%) patients died with a functioning graft and 201 patients (19%) returned to dialysis. After multivariable adjustments, Roma ethnicity was associated with 77% higher risk of all-cause mortality (Hazard Ratio (HR): 1.77; 95% confidence interval (CI): 1.02, 3.07), two times higher risk of mortality with functioning graft (2.04 [1.17-3.55]) and 77% higher risk of graft loss (1.77 [1.01-3.13]), respectively. CONCLUSIONS: Roma ethnicity is independently associated with increased mortality risk and worse graft outcome in kidney transplant recipients. Further studies should identify the factors contributing to worse outcomes among Roma patients.
BACKGROUND: Racial and ethnic disparities among North American patients with chronic kidney disease have received significant attention. In contrast, little is known about health-related outcomes of patients with end-stage renal disease among the Roma minority, also known as gypsies, compared to Caucasian individuals. We prospectively assessed the association between Roma ethnicity and long-term clinical outcomes in kidney transplant recipients. METHODS: In a prevalent cohort of renal transplant recipients, followed up over a median of 94 months, we prospectively collected socio-demographic, medical (and transplant related) characteristics and laboratory data at baseline from 60 Roma and 1,003 Caucasian patients (mean age 45 (SD = 11) and 49 (SD = 13) years, 33 and 41% women, 18 and 17% with diabetes mellitus, respectively). Survival analyses examined the associations between Roma ethnicity and all-cause mortality and death-censored graft loss or death with functioning renal allograft. RESULTS: During the follow-up period, 341 patients (32%) died. Two-hundred eighty (26%) patients died with a functioning graft and 201 patients (19%) returned to dialysis. After multivariable adjustments, Roma ethnicity was associated with 77% higher risk of all-cause mortality (Hazard Ratio (HR): 1.77; 95% confidence interval (CI): 1.02, 3.07), two times higher risk of mortality with functioning graft (2.04 [1.17-3.55]) and 77% higher risk of graft loss (1.77 [1.01-3.13]), respectively. CONCLUSIONS: Roma ethnicity is independently associated with increased mortality risk and worse graft outcome in kidney transplant recipients. Further studies should identify the factors contributing to worse outcomes among Roma patients.
Authors: Sean H Chang; Graeme R Russ; Steven J Chadban; Scott B Campbell; Stephen P McDonald Journal: Transplantation Date: 2007-09-15 Impact factor: 4.939
Authors: Benjamin Cook; Geoffrey Ferris Wayne; Anne Valentine; Anna Lessios; Ethan Yeh Journal: Int J Public Health Date: 2013-10-05 Impact factor: 3.380
Authors: Julian Nikolaus Bucher; Maximilian Koenig; Markus Bo Schoenberg; Alexander Crispin; Michael Thomas; Martin Kurt Angele; Daniela Eser-Valeri; Alexander Lutz Gerbes; Jens Werner; Markus Otto Guba Journal: PLoS One Date: 2019-10-22 Impact factor: 3.240
Authors: Zelmira Macejova; Pavol Kristian; Martin Janicko; Monika Halanova; Sylvia Drazilova; Daniela Antolova; Maria Marekova; Daniel Pella; Andrea Madarasova-Geckova; Peter Jarcuska; HepaMeta Team Journal: Int J Environ Res Public Health Date: 2020-04-29 Impact factor: 3.390