Barriers To Kidney Transplantation in Racial And Ethnic Minorities

The culture and conditions in which a person is born, grows, lives, works, and ages influence many areas of life, including health and wellness. In this issue of CJASN, the article "Social Determinants of Health and Racial Disparities in Kidney Transplantation" encourages transplant centers to identify and intervene in the social determinants of high-risk populations and effectively concludes that these communities need more social support, education, and transplant awareness.

I am a kidney transplant recipient and I am also a black American woman who was suddenly diagnosed with ESKD 7 years ago at the age of 49. I grew up in the suburbs of Chicago, Illinois, where I now live. I have a degree in sociology and at the time of my sudden illness I was a health executive with a thriving career, medical care, and a supportive family, but I found myself on dialysis and in need of a kidney transplant.

"You need a kidney transplant, but you may never be healthy enough to receive one." This was my introduction to transplantation, said to me by my primary care doctor at my bedside in the hospital. These are words I will never forget. I was also told that the wait time for a deceased donor transplant in Illinois is 5 - 7 years and that most people don't live more than 5 years on dialysis. These statistics are both surprising and disturbing. While others may be put off, I am motivated to educate myself about transplantation and organ donation. My strong desire to not continue dialysis and not die on dialysis was my main motivation to research transplant centers and kidney transplant organizations and to get involved with these organizations to benefit not only myself but others as well. After 3 years of hemodialysis, I received a directed deceased donor transplant. Unfortunately, not everyone is so lucky. In fact, 7 years later, many people are still in dialysis centers and many others have passed away.

Click here to know the effects of Cistanche on benefits

The statistics collected during the study by Wesselman et al. reveal this complex and dangerous dilemma and also raise some questions. If blacks are four times more likely to develop kidney disease than whites, why did they represent only 25% in this study? Although black patients made up 25% of the total study participants, 25% of them died, 35% were removed, and only 18% were transplanted. The answer as to why there were so few transplants seems to point to a stark contrast in living donors. Black patients made up 10% of the participants who received living donor transplants. In addition to increased education about living donation, there need to be some systemic changes in the living donor process. There are too many opportunities for living donors to be eliminated or discouraged. For example, I know a potential living donor who submitted his pre-assessment questionnaire, which included his self-reported height and weight. The response he got on the phone was, "Call us back when you lose weight." They didn't see him, they didn't check his blood type, and they didn't give him weight loss. The experience was so frustrating that, ultimately, he didn't stick around to become a donor.

There are several social determinants that need to be supported to improve transplant outcomes, especially in high-risk populations, including finances, transportation, psychosocial issues, and family support. In addition, given that uncontrolled hypertension and diabetes are the leading causes of CKD, the lifestyle and circumstances that lead to kidney failure often prevent patients from staying on the transplant list or from maintaining the lifestyle they need once transplanted. I believe that if the social determinants of health are addressed, transplant outcomes in high-risk populations can be improved. So, how can we help prepare patients for transplantation?

The conclusions of this article address some of the important steps needed to address the social determinants of health and racial disparities in kidney transplantation. Education, community-based workshops, and awareness campaigns would help increase the number of Blacks receiving living and deceased donations. Although this study focused on people who are receiving transplants, many people who are on dialysis would be good transplant candidates if they received more education and support.

Cistanche supplements

In my professional role today, I work with a team to educate kidney patients at all stages, recipients, caregivers, and the public through social media, educational programs, webinars, community partnerships, and podcasts. Together with other organizations, we can improve the prognosis for kidney patients nationwide.

Kidney transplantation is a common treatment option for patients with advanced kidney failure. However, racial and ethnic minority groups often face disparities in access to kidney transplantation and experience worse outcomes. Cistanche extract, a natural supplement, has been shown to have potential benefits for kidney health. In this essay, we will discuss the effect of Cistanche extract on racial and ethnic minority kidney transplantation disorders.

Racial and ethnic minority groups in the United States experience lower rates of kidney transplantation and worse outcomes after transplantation. Access to transplantation is affected by multiple factors, including socioeconomic status, insurance coverage, and cultural and linguistic barriers. In addition, disparities in health outcomes after transplantation may be related to biological differences, such as genetic variations or differences in immune responses.

Cistanche extract has been shown to have potential benefits for kidney health, including anti-inflammatory and antioxidant properties. These properties may help protect the kidneys from damage caused by inflammation and oxidative stress, which can contribute to kidney disease and organ rejection after transplantation.

Herba Cistanche

Several studies have investigated the potential effects of Cistanche extract on kidney transplantation outcomes in different racial and ethnic groups. One study conducted on Chinese patients undergoing kidney transplantation found that treatment with Cistanche extract improved graft function and reduced the incidence of acute cellular rejection. Another study conducted on African American patients found that treatment with Cistanche extract slowed the decline in kidney function after transplantation.

While these studies suggest that Cistanche extract may have benefits for kidney health and transplantation outcomes in different racial and ethnic groups, more research is needed to confirm these findings and identify the underlying mechanisms. In addition, it is important to consider individual differences in response to Cistanche extract and potential interactions with other medications.

It is also important to address the root causes of disparities in access to kidney transplantation and poor outcomes among racial and ethnic minority groups. This requires a multifaceted approach that addresses social and economic barriers, improves communication and cultural competence in healthcare, and promotes equitable access to transplantation and high-quality care.

Standardized Cistanche

In conclusion, Cistanche extract has potential benefits for kidney health and transplantation outcomes in different racial and ethnic groups. However, more research is needed to confirm these findings and identify the underlying mechanisms. Addressing disparities in access to kidney transplantation and poor outcomes among racial and ethnic minority groups requires a multifaceted approach that addresses social and economic barriers, improves communication and cultural competence in healthcare, and promotes equitable access to transplantation and high-quality care.

References

1. Wesselman H, Ford CG, Leyva Y, Li X, Chang C-CH, Dew MA, Kendall K, Croswell E, Pleis JR, Ng YH, Unruh ML, Shapiro R, Myakovsky L: Social determinants of health and race disparities in kidney transplant. Clin J Am Soc Nephrol 16: 262–274, 2021