International Urology and Nephrology

, Volume 44, Issue 3, pp 945–954 | Cite as

Roma ethnicity and clinical outcomes in kidney transplant recipients

  • Miklos Z. Molnar
  • Robert M. Langer
  • Adam Remport
  • Maria E. Czira
  • Katalin Rajczy
  • Kamyar Kalantar-Zadeh
  • Csaba P. Kovesdy
  • Marta Novak
  • Istvan Mucsi
  • Laszlo Rosivall
Nephrology - Original Paper



Racial and ethnic disparities among North American patients with chronic kidney disease have received significant attention. In contrast, little is known about health-related outcomes of patients with end-stage renal disease among the Roma minority, also known as gypsies, compared to Caucasian individuals. We prospectively assessed the association between Roma ethnicity and long-term clinical outcomes in kidney transplant recipients.


In a prevalent cohort of renal transplant recipients, followed up over a median of 94 months, we prospectively collected socio-demographic, medical (and transplant related) characteristics and laboratory data at baseline from 60 Roma and 1,003 Caucasian patients (mean age 45 (SD = 11) and 49 (SD = 13) years, 33 and 41% women, 18 and 17% with diabetes mellitus, respectively). Survival analyses examined the associations between Roma ethnicity and all-cause mortality and death-censored graft loss or death with functioning renal allograft.


During the follow-up period, 341 patients (32%) died. Two-hundred eighty (26%) patients died with a functioning graft and 201 patients (19%) returned to dialysis. After multivariable adjustments, Roma ethnicity was associated with 77% higher risk of all-cause mortality (Hazard Ratio (HR): 1.77; 95% confidence interval (CI): 1.02, 3.07), two times higher risk of mortality with functioning graft (2.04 [1.17–3.55]) and 77% higher risk of graft loss (1.77 [1.01–3.13]), respectively.


Roma ethnicity is independently associated with increased mortality risk and worse graft outcome in kidney transplant recipients. Further studies should identify the factors contributing to worse outcomes among Roma patients.


Roma ethnicity Kidney transplantation Mortality, graft loss 



This study was supported by grants from the National Research Fund (OTKA) (KTIA-OTKA-EU 7KP-HUMAN-MB08-A-81231), ETT (206/09), the Hungarian Kidney Foundation, Hungarian Society of Hypertension, Hungarian Society of Nephrology and the Foundation for Prevention in Medicine. MZM received grants from the National Developmental Agency (KTIA-OTKA-EU 7KP-HUMAN-MB08-A-81231) from the Research and Technological Innovation Fund, was also supported by Hungarian Kidney Foundation. The research of M. Novak has been supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences (2008–2011) and the Center for Integrative Mood Research, Toronto, Canada.

Conflict of interest


Supplementary material

11255_2011_88_MOESM1_ESM.doc (34 kb)
Supplementary material 1 (DOC 34 kb)


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Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • Miklos Z. Molnar
    • 1
    • 2
    • 3
  • Robert M. Langer
    • 4
  • Adam Remport
    • 5
  • Maria E. Czira
    • 2
  • Katalin Rajczy
    • 6
  • Kamyar Kalantar-Zadeh
    • 3
    • 7
  • Csaba P. Kovesdy
    • 8
    • 9
  • Marta Novak
    • 2
    • 10
  • Istvan Mucsi
    • 1
    • 2
    • 11
  • Laszlo Rosivall
    • 1
  1. 1.Institute of PathophysiologySemmelweis UniversityBudapestHungary
  2. 2.Institute of Behavioral SciencesSemmelweis UniversityBudapestHungary
  3. 3.Harold Simmons Center for Chronic Disease Research and EpidemiologyLos Angeles Biomedical Research Institute at Harbor-UCLATorranceUSA
  4. 4.Department of Transplantation and SurgerySemmelweis UniversityBudapestHungary
  5. 5.Division of NephrologySzent Imre HospitalBudapestHungary
  6. 6.Hungarian National Blood Transfusion ServicerBudapestHungary
  7. 7.UCLA David Geffen School of MedicineLos AngelesUSA
  8. 8.Division of NephrologySalem VA Medical CenterSalemUSA
  9. 9.Division of NephrologyUniversity of VirginiaCharlottesvilleUSA
  10. 10.Department of PsychiatryUniversity Health Network, University of TorontoTorontoCanada
  11. 11.Division of Nephrology, Department of MedicineMcGill University Health CenterMontrealCanada

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