The influence of race on kidney graft survival

Similar outcomes among black and white renal allograft recipients

Black renal transplant recipients experience shorter graft survival than white recipients, but no published data describe the graft outcomes among black Canadian recipients. Here, we analyzed data from the Canadian national renal replacement therapy registry, which included 20,243 incident dialysis patients (3% black, 97% white), 5036 of whom received a renal transplant during the study period. Black patients were significantly less likely to receive a renal transplant (deceased and living-donor combined) when compared with white patients (hazard ratio 0.59; 95% confidence interval 0.51 to 0.69; P < 0.0001). Among patients who underwent a renal transplant, there was no significant difference in the likelihood of graft failure between black and white patients, even after adjustment for comorbidities and socioeconomic status; black patients, however, had significantly lower posttransplantation mortality compared with white patients (hazard ratio 0.49; 95% confidence interval 0.28 to 0.88; P = 0.02). In conclusion, graft outcomes between black and white Canadian renal transplant patients are similar. Because this differs from the experience reported from the United States, further direct comparisons between the two populations is warranted.