The increasing incidence of end-stage renal disease proves the need for more education is vital to reducing racial disparity in organ donation and transplantation.
While 13 percent of the United States population is African American, nearly 33 percent of those awaiting kidney transplants nationally are African American, due predominantly to end stage renal disease (ESRD) caused by hypertension and type 2 diabetes mellitus. The incidence of ESRD in African Americans is 3.7 times greater than in Caucasians. This disparity is more pronounced in the southern states where African Americans make up greater than 60 percent of those awaiting kidney transplantation. These numbers spotlight the epidemic of kidney disease, hypertension, and diabetes as well as the predominant need for dialysis in this ethnic group.
The effectiveness of education and community awareness is evidenced by the modest increase in national rates of organ donation among African Americans, increasing from 11 percent in 1994 to 15 percent in 2019. These numbers do not reflect the work being done in different regions such as Washington D.C., where 70 percent of donors are African American. However, there is still much work to be done to move the needle towards increasing consent rate for donation on a wider national level.
Much more work is needed to address ESRD disparities in African Americans, as well as the issues associated with access to transplantation, especially live donor kidney transplants. The overwhelming incidence of hypertension, together with diabetes, obesity, and poor knowledge of treatment choices place many patients at a disadvantage.