Date: Sunday, June 12, 2016
Session Name: Poster Session B: Disparities in Access and Outcomes
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Non-adherence is considered to a be a strong risk factor for graft loss in kidney transplant recipients, with conflicting evidence of its impact on disparities in African-American (AA) kidney transplant recipients.
Methods: Retrospective longitudinal cohort study of adult kidney transplant recipients transplanted between 2005 and 2014 with the aim of determining the incidence and impact of early appointment and medication non-adherence (within 1 yr of transplant), stratified by race (AA vs. non-AA). Pediatrics, multi-organ recipients and those with graft loss or follow up of less than one year were excluded.
Results: 1,307 kidney transplants were included in the analysis; of which 620 (47%) were non-AAs and 687 (53%) were AA recipients; 19.5% of AAs had documented medication (2.2%) or appointment (18.0%) non-adherence within one year of transplant, compared to 12.1% of non-AAs (OR 1.76, 95% CI 1.30-2.39; p<0.001). Early non-adherence was significantly associated with acute rejection in AA kidney transplant recipients, but not in non-AAs (Figure 1). Likewise, early non-adherence was significantly associated with hospital readmission in AAs (p=0.026), but not in non-AAs (p=0.694). Graft loss tended to be higher in those with early non-adherence (p=0.175), which was more pronounced in AA kidney transplant recipients (Figure 2).
Conclusion: AA kidney transplant recipients appear to have higher rates of early non-adherence, driven mainly by missed appointments. Early non-adherence is significantly associated with acute rejection and hospital readmission in AAs, but does not explain the higher rates of graft loss. Further research is needed to understand the causes of non-adherence in this high-risk kidney transplant population.
CITATION INFORMATION: Taber D, Chokkalingam A, Posadas A, Browning R, Salazar N, Kamel M, Pullalarevu R, Kadri B, Srinivas T, Chavin K, Baliga P. The Impact of Non-Adherence on Disparities in African-American Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Taber D, Chokkalingam A, Posadas A, Browning R, Salazar N, Kamel M, Pullalarevu R, Kadri B, Srinivas T, Chavin K, Baliga P. The Impact of Non-Adherence on Disparities in African-American Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-non-adherence-on-disparities-in-african-american-kidney-transplant-recipients/. Accessed December 5, 2020.
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