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. 2024 Jul;38(7):e15382.
doi: 10.1111/ctr.15382.

Components of Residential Neighborhood Deprivation and Their Impact on the Likelihood of Live-Donor and Preemptive Kidney Transplantation

Yiting Li  1 , Gayathri Menon  1 , Byoungjun Kim  1   2 , Maya N Clark-Cutaia  3   4 , Jane J Long  1 , Garyn T Metoyer  1 , Dinushika Mohottige  5 , Alexandra T Strauss  6 , Nidhi Ghildayal  1 , Evelien E Quint  7 , Wenbo Wu  2   4 , Dorry L Segev  1   2 , Mara A McAdams-DeMarco  1   2
Affiliations

Components of Residential Neighborhood Deprivation and Their Impact on the Likelihood of Live-Donor and Preemptive Kidney Transplantation

Yiting Li et al. Clin Transplant. 2024 Jul.

Abstract

Introduction: Adults residing in deprived neighborhoods face various socioeconomic stressors, hindering their likelihood of receiving live-donor kidney transplantation (LDKT) and preemptive kidney transplantation (KT). We quantified the association between residential neighborhood deprivation index (NDI) and the likelihood of LDKT/preemptive KT, testing for a differential impact by race and ethnicity.

Methods: We studied 403 937 adults (age ≥ 18) KT candidates (national transplant registry; 2006-2021). NDI and its 10 components were averaged at the ZIP-code level. Cause-specific hazards models were used to quantify the adjusted hazard ratio (aHR) of LDKT and preemptive KT across tertiles of NDI and its 10 components.

Results: Candidates residing in high-deprivation neighborhoods were more likely to be female (40.1% vs. 36.2%) and Black (41.9% vs. 17.7%), and were less likely to receive both LDKT (aHR = 0.66, 95% confidence interval [CI]: 0.64-0.67) and preemptive KT (aHR = 0.60, 95% CI: 0.59-0.62) than those in low-deprivation neighborhoods. These associations differedby race and ethnicity (Black: aHRLDKT = 0.58, 95% CI: 0.55-0.62; aHRpreemptive KT = 0.68, 95% CI: 0.63-0.73; Pinteractions: LDKT < 0.001; Preemptive KT = 0.002). All deprivation components were associated with the likelihood of both LDKT and preemptive KT (except median home value): for example, higher median household income (LDKT: aHR = 1.08, 95% CI: 1.07-1.09; Preemptive KT: aHR = 1.10, 95% CI: 1.08-1.11) and educational attainments (≥high school [LDKT: aHR = 1.17, 95% CI: 1.15-1.18; Preemptive KT: aHR = 1.23, 95% CI: 1.21-1.25]).

Conclusion: Residence in socioeconomically deprived neighborhoods is associated with a lower likelihood of LDKT and preemptive KT, differentially impacting minority candidates. Identifying and understanding which neighborhood-level socioeconomic status contributes to these racial disparities can be instrumental in tailoring interventions to achieve health equity in LDKT and preemptive KT.

Keywords: live‐donor kidney transplantation; neighborhood deprivation; preemptive kidney transplantation.

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Conflict of interest statement

Disclosures: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.. Individual components of the Neighborhood Deprivation Index (NDI) and the likelihood of receiving Live-Donor Kidney Transplantation (LDKT).
Each component was Z-standardized.
See this image and copyright information in PMC

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