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Roma ethnicity and clinical outcomes in kidney transplant recipients

  • Nephrology - Original Paper
  • Published:
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Abstract

Background

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.

Methods

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.

Results:

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.

Conclusions

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.

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Acknowledgments

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

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Author information

Authors and Affiliations

  1. Institute of Pathophysiology, Semmelweis University, 4 Nagyvarad ter, 1089, Budapest, Hungary

    Miklos Z. Molnar, Istvan Mucsi & Laszlo Rosivall

  2. Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary

    Miklos Z. Molnar, Maria E. Czira, Marta Novak & Istvan Mucsi

  3. Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA

    Miklos Z. Molnar & Kamyar Kalantar-Zadeh

  4. Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary

    Robert M. Langer

  5. Division of Nephrology, Szent Imre Hospital, Budapest, Hungary

    Adam Remport

  6. Hungarian National Blood Transfusion Servicer, Budapest, Hungary

    Katalin Rajczy

  7. UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Kamyar Kalantar-Zadeh

  8. Division of Nephrology, Salem VA Medical Center, Salem, VA, USA

    Csaba P. Kovesdy

  9. Division of Nephrology, University of Virginia, Charlottesville, VA, USA

    Csaba P. Kovesdy

  10. Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada

    Marta Novak

  11. Division of Nephrology, Department of Medicine, McGill University Health Center, Montreal, QC, Canada

    Istvan Mucsi

Authors
  1. Miklos Z. Molnar
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  2. Robert M. Langer
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  3. Adam Remport
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  4. Maria E. Czira
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  5. Katalin Rajczy
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  6. Kamyar Kalantar-Zadeh
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  7. Csaba P. Kovesdy
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  8. Marta Novak
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  9. Istvan Mucsi
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  10. Laszlo Rosivall
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Corresponding author

Correspondence to Miklos Z. Molnar.

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Molnar, M.Z., Langer, R.M., Remport, A. et al. Roma ethnicity and clinical outcomes in kidney transplant recipients. Int Urol Nephrol 44, 945–954 (2012). https://doi.org/10.1007/s11255-011-0088-6

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  • DOI: https://doi.org/10.1007/s11255-011-0088-6

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