SLU doctors urge Black people to enter kidney research to boost transplant outcomes
The kidney transplant team at St. Louis University Hospital is urging African Americans in the St. Louis region to participate in research to help improve kidney treatment transplant outcomes.
Black Americans are four times as likely to develop kidney failure as white Americans. SLU’s transplant team is working with the National Institutes of Health on new research to help address racial disparities in kidney transplant outcomes.
Researchers across the country also are reassessing how doctors use race when treating people with chronic kidney disease. A recent study on kidney transplant outcomes found that some of the higher risk of transplant failure assigned to African Americans owes to the way researchers code a gene found in some people of sub-Saharan African ancestry.
Categorizing race as a biologic construct, rather than a social one, contributes to health care disparities in kidney treatment and transplants, said Dr. Krista Lentine, co-director of research at St. Louis University Hospital Transplant Center.
“These disparities occur at many levels, including in the risk of kidney disease developing itself, access to transplant, referral and waitlist, as well as the types of organs the patients receive, all of which can impact critical outcomes like patient survival,” said Lentine, who also co-leads the research at SLU Hospital.
St. Louis University’s transplant center is one of 13 clinics across the nation that are participating in a four-year national study funded by NIH. SLU Hospital transplant researchers aim to examine whether the gene of the kidney transplant recipient plays a role in the outcome.
That information could help determine whether doctors replace race as a risk factor.
Some African Americans tend to have more advanced stages of kidney disease because of inequities that start with transplant referrals, said Dr. Henry Randall, transplant division chief at St. Louis University Hospital.
Randall said the health care system has failed to provide Black Americans with access to transplants. He said nephrologists should start referring people sooner for transplants so they won’t languish on the list and become too sick for a transplant.
Nikki Love-McIntyre, 49, of Belleville, was diagnosed with Type 1 diabetes at 20. She managed the disease for about 20 years before she needed a kidney transplant.
Love-McIntyre would not have known she needed a transplant if she had not gone to the hospital in 2014 after she experienced swelling and had trouble breathing. A few days after she returned home, her doctor told her to see a nephrologist immediately because she had stage 3 kidney disease.
“I think a lot of people don't know that diabetes is a killer, it is a beast,” Love-McIntyre said. “It deals with so much stuff body wise, it affects your eyes and affects the heart and of course your kidneys.”
Love-McIntyre received a kidney and pancreas transplant in October 2015. She received a pancreas transplant because hers did not produce enough insulin. Doctors told her that without a pancreas transplant, her new kidney would only last for about five years. Because Love-McIntyre needed two organs, she was placed on the top of the transplant list, allowing her to receive the organs faster than expected.
Love-McIntyre, who no longer lives with diabetes because of her transplants, tries to urge other Black people to manage their diabetes. She also tells people what to expect from transplant surgery.
She said many Black people do not seek treatment for diabetes because they lack insurance and access to facilities. Some are afraid to visit the doctor.
“They feel like something is wrong with them, but they're just scared to go for fear of what the doctor is going to say is wrong with them,” Love-McIntyre said.
To help break down some of those barriers for African Americans, SLU Hospital’s transplant team is encouraging more African Americans to participate in the last year of the nationwide study.
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