South Asian and Muslim Canadian Patients are less Likely to Receive Living Donor Kidney Transplant offers Compared to Caucasian, Non-Muslim Patients
Notice bibliographique
Résumé
Background Patients with End-Stage Kidney Disease (ESKD) who belong to ethnocultural minorities are less likely to receive Living Donor Kidney Transplant (LDKT) compared to Caucasian patients. However, no studies have assessed whether Muslim Canadians face similar barriers to accessing LDKT. We explored how frequently Muslim or South Asian patients with ESKD receive LDKT offers and if they had a potential living donor (LD) identified and how this compares to Caucasian patients. Methods We used a cross-sectional, convenience sample of ESKD patients over 18 years of age from several hospitals in the Greater Toronto Area. Non-English speaking patients and patients unwilling to consent were excluded. Based on self-identified religious affiliation and ethnicity patients were grouped as: 1) Muslims 2) Caucasian, Non-Muslims 3) South Asian, Non-Muslims 4) Non-Caucasian, Non-Muslims. Patients were asked whether anyone had offered to be a living donor for them and if they had a LD identified (outcome variables). Univariable and multivariable logistic regression was used to analyze the association between religion/ethnicity and outcome variables in STATA14. Results Out of 367 participants 5% (18) were Muslim, 37% (134) Caucasian, non-Muslim and 12% (44) South Asian, non-Muslim. The mean (±SD) age was 58(±13) years, 60%(221) were male. Muslim patients tended to be younger in comparison to Caucasian, non-Muslims (53[±14] versus 58[±14] years, p=0.074). Compared to Caucasian, Non-Muslims, Muslim patients tended to be less likely to report receiving an offer for living donation (OR=0.47, CI: 0.17-1.30, P=0.147), although the association was significant only after adjusting for age, gender, and education (OR=0.32, CI: 0.11-0.96, P=0.043). South Asian, Non-Muslims, in comparison to Caucasian, Non-Muslims, also seemed to be less likely to report receiving an offer for living donation (OR=0.64, CI: 0.32-1.25, P=0.190). The association tended to be significant after adjusting for age, gender, and education (OR=0.48, CI: 0.23-1.01, P=0.052). Qualitatively similar results were seen for “having a potential living donor identified” in both groups. Discussion Muslim patients with ESKD are less likely to receive a living kidney donation offer than Caucasian, Non-Muslims. A similar trend was seen for South Asian non-Muslims. An unclear understanding of the Islamic perspective on organ donation and additional cultural or religious factors may contribute to the observed inequity. Limitations in this study are the small number of Muslim and South Asian patients, and cross-sectional design. Conclusion Muslim and South Asian patients with ESKD are less likely to receive a living kidney donation offer compared to Caucasian, Non-Muslims. These patients are, therefore, less likely to receive a LDKT. Culturally competent education may help to reduce these inequities.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».