ヒスパニック系コミュニティの腎臓移植へのアクセスに関する地理的洞察
Stalin Cañizares1, Bruna Trindade2, Gabriel Cojuc-Konigsberg3
1Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Journal of racial and ethnic health disparities
|August 27, 2025
まとめ
ヒスパニック系末期性腎臓病 (ESKD) の患者の腎臓移植へのアクセスには地理的な格差が残っています. ESKDを患っているヒスパニック系の人々を 対象としたアウトリーチと新しいセンターが必要です
科学分野:
- 腎臓科
- 公衆衛生
- 医療サービス研究
背景:
- 米国で増加するヒスパニック系の人口は 末期性腎臓病 (ESKD) の大きなリスクに直面しています
- 腎臓移植へのアクセスは ヒスパニック系コミュニティにとって 課題です
- ヒスパニック系ESKD患者の腎臓移植センター (KTC) へのアクセスが限られている地域を特定することは極めて重要です.
研究 の 目的:
- KTCへのアクセスが限られている ESKDを患っているヒスパニック系の人が多い地域を特定する.
- ヒスパニック系腎臓クリニック (H-KTC) の移植率への影響を評価する.
主な方法:
- UNOSのデータベース (2018-2022) を利用してKTCを特定した.
- ヒスパニック系の人々 (2021 USRDS) の郡レベルのESKDの罹患率と死亡率データを分析した.
- KTC に近いヒスパニック人口を特定し,ESKD の流行と死亡率の空間的なクラスターを特定するために,地理空間分析を行った.
主要な成果:
- ESKDを持つヒスパニック人の割合は,KTCの2時間の運転時間 (0.23%対0.21%) 以外にあります.
- ヒスパニック系ESKD患者の死亡率は,2時間運転圏外で高かった (11. 4% vs 10. 2%),南西部の死亡率は顕著であった.
- H-KTCの実施は,ヒスパニック系受容者1人当たりの腎臓移植の平均値 (81から109,p=0.006) を著しく増加させた.
結論:
- 現存するKTCは戦略的に位置していますが,ヒスパニック系ESKDのアクセスには大きなギャップが残っています.
- ヒスパニック系ESKDが多い地域では KTCへのアクセスが限られているが,集中的なアウトリーチが必要である.
- 新しいまたは既存のKTCを通じてサービスの拡大は,サービス不足のヒスパニックコミュニティの移植アクセスを改善するために推奨されます.
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