# The effect of socioeconomic status and environment characteristics on disparate postdonation health outcomes between Black and White living kidney donors

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2020 · $85,306

## Abstract

PROJECT SUMMARY/ABSTRACT
Each year in the US, 6000+ healthy individuals donate a kidney to a loved one, friend or stranger amounting to
142,111 individuals who have donated since 1988. For these healthy individuals, live donor nephrectomy is
associated with a 25-40% decline in renal function, which increases their risk for chronic kidney disease (CKD)
and end-stage renal disease (ESRD). However, recent evidence suggests that Black living kidney donors are
at an even higher risk of these long-term morbidities than White donors. The 15-year postdonation risk of
ESRD for Black donors is 154 per 10,000 compared to 49 per 10,000 for White donors. While compelling
evidence points to genetic risk factors as key components of this difference, a substantial knowledge gap
exists regarding the contribution of socioeconomic status (SES) and local environment of donors.
Routine postdonation follow-up and care management could potentially identify early events on the pathway to
CKD and ESRD – including diabetes (DM), hypertension (HTN) and glomerulonephritis (GN) as these
conditions are easily detected with routine vital signs, and blood and urine tests. Our group recently reported
that only 50% of transplant hospitals achieve the mandated, routine follow-up for their donors. Further, follow-
up attrition is associated with donors that are young, black, male, uninsured, and with fewer years of education.
It is possible that socioeconomic and local environment disadvantage may potentiate follow-up attrition and
increase rate of progression to CKD/ESRD in an already genetically at risk population.
To better understand the impact of SES and environment on post-donation CKD/ESRD, we will leverage a
major, ongoing, R01-funded, multicenter study that uses survey data linked to administrative databases to
address the following aims: (1) To characterize the SES and local environment resources of Black vs. White
living kidney donors; (2) To quantify the postdonation risk of CKD/ESRD attributable to low SES and
disadvantaged environments; and (3) To examine health behavior of Black vs. White donors according to SES
and environment. These aims are highly feasible given the rich primary data collection of parent study.
We hypothesize that Black and White donors with low SES and from disadvantaged environments will have a
higher incidence of postdonation DM, HTN, GN and CKD/ESRD. If the proposed aims are achieved, we will
have a better understanding of which variables modify the relationship between race and outcomes and at
what threshold of social disadvantage a difference is observed. It could also change clinical practice by 1)
informing personalized follow-up care plans based on donor social circumstances, and (2) preventing exclusion
of disadvantaged populations from national-based monitoring interventions.

## Key facts

- **NIH application ID:** 9949704
- **Project number:** 5F32DK117563-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Amber Kernodle
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $85,306
- **Award type:** 5
- **Project period:** 2018-07-01 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9949704

## Citation

> US National Institutes of Health, RePORTER application 9949704, The effect of socioeconomic status and environment characteristics on disparate postdonation health outcomes between Black and White living kidney donors (5F32DK117563-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9949704. Licensed CC0.

---

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