By Nancy Lapid
March 9 (Reuters) – Black patients with failing kidneys are receiving more transplants and spending less time on transplant waiting lists, after decades in which race-based medical guidelines led to under-diagnosis of kidney disease and fewer transplants in those patients, according to a report published on Monday.
New U.S. policies are having a noticeably positive impact on outcomes of Black kidney patients, researchers said in a report published in JAMA Internal Medicine.
“Our findings indicate that reparative approaches to address the harms caused by race-based clinical algorithms can help move the needle toward health equity,” study leader Dr. Rohan Khazanchi of Brigham and Women’s Hospital and Boston Medical Center said in a statement.
In some cases, Black patients who had been kept alive by dialysis for years while awaiting a new kidney received a transplant within months after the severity of their disease was reassessed using a race-neutral formula, surgeons not involved in the new study told Reuters. These patients were likely still years from reaching the top of the transplant list under the old system, they said.
Historically, to receive a diagnosis of kidney disease, Black patients needed worse renal function than white patients.
In 2021, to address this inequity, race was removed from equations for estimating renal function. Two years later, U.S. hospitals were ordered to reassess their kidney transplant waiting lists and correct the status of Black patients whose kidney disease severity had been assessed by the old formula.
As of June 2025, 21,119 Black patients waiting for transplants had been moved up on waiting lists, resulting in an increase of 5.3 transplants per 1,000 Black candidate listings, without significant changes in transplant rates among non-Black and/or Hispanic candidates, according to the report.
“Black patients and other marginalized groups are still not transplanted equitably despite being diagnosed with end-stage kidney disease at much higher rates, so there remains a continued need for accountability and intervention to ensure that all communities are equitably prioritized,” Khazanchi said.
Recent efforts to end collection of race and ethnicity data in the U.S. Renal Data System risk erasing decades of progress in monitoring and intervening on kidney transplant inequities, the researchers said.
(Reporting by Nancy Lapid; Editing by Bill Berkrot)
