KIDNEY TRANSPLANT AND DONATION DISPARITIES
Black donors were 2.35 times more likely to have a KDPI >85% (high risk), leading to increased non-use of these organs.
Kidney transplants are the only cure for failing kidneys. Despite higher rates of diagnosed disease, the average wait time for Black patients to receive a kidney transplant is a year longer than white patients, whose typical wait time is already of 3 to 5 years.
For disparities related to overall kidney health, visit our EGFR page.
IMPACT OF THE ALGORITHM
How does the KDRI algorithm work?
The KDRI predicts how likely a donated kidney is to work in the long term after a transplant. There is also the Kidney Donor Profile Index (KDPI), which is a score (based on the KDRI) that that helps doctors compare donated kidneys. It combines information about the donor into one number to show how a kidney compares to other donated kidneys across the country. A table mapping KDRI to KDPI and a calculator for KDPI based on the most recent registry data are available on the Organ Procurement and Transplantation Network website.
The algorithm accounts for 10 variables: Age, Height, Weight, History of Hypertension, History of Diabetes, Serum Creatinine, HCV Status, Cause of Death, Donation after Circulatory Death Status, and Ethnicity (African American/non-African American).
How does the KDRI algorithm contribute to disparities?
The estimated risk of graft failure is 18% greater in Black donors leading to organs being discarded rather than transplanted.
The United Network for Organ Sharing often considers the distance a patient lives to the donor kidney when determining who receives a kidney. Due to long-standing residential segregation, this system has made it less likely for Black Americans to receive a kidney transplant.
The exclusion of race in the KDRI algorithm makes more kidneys available for transplant. IT also allows other, more relevant clinical factors, to be considered when predicting the success of a kidney transplant.
What is the current KDRI/KDPI calculator?
As of October 2024, the calculator no longer includes race as a variable. This helps improve equity in organ allocation for transplant.
COALITION IMPACT
All health systems in the Coalition to Eliminate Race-Based Medicine have updated their KDRI/KPRI equation to remove race as a variable.