In terms of treatment options, living donor kidney transplantation is the best available for patients with end-stage renal disease (ESRD). It offers considerably better outcomes than dialysis or deceased donor transplantation. In African Americans, living donor transplantation is less frequent than in white individuals, a difference that could be due to a number of reasons. However, it seems that this disparity can primarily be attributed to differences in socioeconomic status, according to a new study.

Jagbir Gill and his colleagues used data from the US Census Bureau and the United Network for Organ Sharing. “We stratified the US population by race (African American and White) and zip code level median household income and examined the incidence of living kidney donation within each group. We additionally adjusted for factors including age, gender, ESRD, and geographic factors in each analysis. To assess the associations between living organ donation and donor median household income and race,” explains Gill.

Interestingly, the total incidence of living kidney donation was significantly higher in the African-American population than the white population. However, these ratios varied according to income. Indeed, median household income determined at the zip code level was strongly associated with living kidney donation: the incidence of living kidney donation was greater in higher income populations and significantly reduced in lower income populations. This connection was independent of race.

Gill points out that, “these data suggest that socioeconomic status may be the major barrier to living kidney donation in African American populations rather than cultural factors, which would be expected to be a factor at all socioeconomic levels.”