# Racial disparities in access to kidney transplantation

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $702,928

## Abstract

Project Abstract/Summary
Kidney transplantation is the preferred modality of treatment for end-stage kidney disease (ESKD) and is
known to improve quality of life and survival of patients compared with dialysis. However, racial and ethnic
disparities in access to kidney transplantation have persisted for more than two decades. The lower access of
Black and Hispanic adults to kidney transplantation has been attributed to individual-level characteristics such
as socioeconomic barriers, differences in cultural beliefs or attitudes surrounding organ transplantation, and
higher prevalence of contraindications to kidney transplantation. However, system-level factors may contribute
to the racial and ethnic inequities in access to kidney transplantation, but have not been thoroughly explored.
In this renewal application, we propose to leverage electronic health record data to examine the role of
providers and provider-patient interactions on inequities in access to referral for kidney transplant candidacy
evaluation and waitlisting at University of California healthcare systems, Hennepin Healthcare, University of
Minnesota, University of Maryland, and University of Texas Southwestern. We will focus on patients with CKD
stage 4-5 who would potentially be eligible for referral for kidney transplantation in our study. In Aim 1, we will
determine whether race/ethnicity associates with the language used in provider notes (positive or negative)
and frequency of provider-patient interactions or monitoring. In Aim 2, we propose to evaluate whether these
factors mediate the association between race/ethnicity and outcomes including preemptive referral for kidney
transplant candidacy evaluation or transplant center decisions surrounding a patient’s eligibility for waitlisting.
In Aim 3, we will then relate the language used in provider notes to outcomes following the onset of ESKD,
such as first-year mortality and post-transplant outcomes (hospitalizations, rejection, and graft failure). We are
particularly interested in the strength of these associations by race/ethnicity and whether effect modification is
present. The results of our study will enhance our understanding of mediators of racial and ethnic disparities in
access to transplantation and inform the design of interventions that can be delivered to address provider-
related variables that may contribute to inequities in access to kidney transplantation.

## Key facts

- **NIH application ID:** 10905609
- **Project number:** 2R01DK115629-05A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** R. Adams Dudley
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $702,928
- **Award type:** 2
- **Project period:** 2017-12-06 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10905609

## Citation

> US National Institutes of Health, RePORTER application 10905609, Racial disparities in access to kidney transplantation (2R01DK115629-05A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10905609. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*