The role of disparities and socioeconomic factors in access to kidney transplantation and its outcome

Tammy Hod, Alexander S. Goldfarb-Rumyantzev*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Background: Research focused on identifying vulnerable populations and revealing specific risk factors for barriers along the pathway from ESRD to kidney transplantation has been mostly descriptive and the causes of existing disparities remain unclear. However, several socio-economic factors that are associated with the access to and the outcome of the kidney transplantation have been identified. Summary: While the presence of racial, gender, and geographic disparities is noted, we were interested mostly to describe potential socio-economic factors associated with and possibly responsible for the presence of such disparities. In this review we focused on five factors: education level, employment status, income, presence of substance addiction or abuse, and marital status. We describe the new method to quantify patients' socio-economic status and identify the group of high risk in terms of the transplant outcome, easily calculated social adaptability index, previously associated with clinical outcome in several patient populations including those with kidney transplant. At the end, based on literature analyzed we offer potential interventions that potentially can be used in order to reduce the degree of disparities. Conclusion: Based on review of literature socio-economic factors are associated with and possibly responsible for healthcare disparities. Social adaptability index allows quantifying the degree of socio-economic status and identifying the group of high risk for inferior transplant outcome.

Original languageEnglish
Pages (from-to)1193-1199
Number of pages7
JournalRenal Failure
Issue number8
StatePublished - Sep 2014
Externally publishedYes


  • Access to transplantation
  • Disparities
  • Education
  • Employment
  • Outcome
  • Renal transplantation
  • Social adaptability index
  • Socio-economic factors


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