Yeates Karen, Wiebe Natasha, Gill John, Sima Camelia, Schaubel Douglas, Holland David, Hemmelgarn Brenda, Tonelli Marcello
Department of Medicine, Queen's University, 94 Stuart Street, Kingston, Ontario, Canada.
J Am Soc Nephrol. 2009 Jan;20(1):172-9. doi: 10.1681/ASN.2007070820. Epub 2008 Oct 29.
Black renal transplant recipients experience shorter graft survival than white recipients, but no published data describe the graft outcomes among black Canadian recipients. Here, we analyzed data from the Canadian national renal replacement therapy registry, which included 20,243 incident dialysis patients (3% black, 97% white), 5036 of whom received a renal transplant during the study period. Black patients were significantly less likely to receive a renal transplant (deceased and living-donor combined) when compared with white patients (hazard ratio 0.59; 95% confidence interval 0.51 to 0.69; P < 0.0001). Among patients who underwent a renal transplant, there was no significant difference in the likelihood of graft failure between black and white patients, even after adjustment for comorbidities and socioeconomic status; black patients, however, had significantly lower posttransplantation mortality compared with white patients (hazard ratio 0.49; 95% confidence interval 0.28 to 0.88; P = 0.02). In conclusion, graft outcomes between black and white Canadian renal transplant patients are similar. Because this differs from the experience reported from the United States, further direct comparisons between the two populations is warranted.
黑人肾移植受者的移植物存活时间比白人受者短,但尚无已发表的数据描述加拿大黑人受者的移植物结局。在此,我们分析了加拿大全国肾脏替代治疗登记处的数据,该数据包括20243例新发透析患者(3%为黑人,97%为白人),其中5036例在研究期间接受了肾移植。与白人患者相比,黑人患者接受肾移植(包括尸体供肾和活体供肾)的可能性显著降低(风险比0.59;95%置信区间0.51至0.69;P<0.0001)。在接受肾移植的患者中,即使在调整合并症和社会经济地位后,黑人和白人患者移植物失败的可能性也没有显著差异;然而,黑人患者移植后的死亡率显著低于白人患者(风险比0.49;95%置信区间0.28至0.88;P = 0.02)。总之,加拿大黑人和白人肾移植患者的移植物结局相似。由于这与美国报告的情况不同,因此有必要对这两个人群进行进一步的直接比较。