ACCESS OF NATIVE-AMERICANS TO RENAL-TRANSPLANTATION IN ARIZONA AND NEW-MEXICO

Lower rates of transplantation among minority groups are a nationally recognized phenomenon. Native Americans (NA) nationally have nearly fo ur times the risk of end-stage renal disease (ESRD) as compared with w hite (W) Americans and are significantly overrepresented in the Networ k 15 ESRD population. To understand more about NA and W transplant rat es, we looked at all reported Arizona (AZ) and New Mexico (NM) residen t cases from the Network No. 15 data base. Age of onset, sex, primary diagnosis, payment source, transplant donor source, and other factors were examined. NA experienced a slightly earlier onset of ESRD than W, and diabetes mellitus was the primary ESRD diagnosis for 63-73% of NA and for 34-39% of W. Because age distribution and frequency of diabet es mellitus of the NA ESRD population differ from those of W in the Ne twork, age-specific and diagnosis-specific transplant rates were exami ned. Age-adjusted transplant rates per 100 ESRD patients for AZ were 1 6.4 (NA) and 21.0 (W) and for NM 14.2 (NA) and 22.4 (W). Diagnosis-spe cific age-adjusted transplant rates for patients with the primary diag noses of diabetes mellitus and glomerulonephritis, the two most common causes of ESRD among NA, showed a large difference between W and NA r ates. Age-adjusted rates for diabetics were: AZ 8.5% (NA) and 14.5% (W ); NM 9.8% (NA) and 15.9% (W). Age-adjusted rates for patients with gl omerulonephritis were: AZ 23.7% (NA) and 28.0% (W); NM 22.3% (NA) and 33.0% (W). In all comparisons and in both the W and NA ESRD population s, women were transplanted at lower rates than men. NA experienced a g reater delay from onset of treated ESRD to transplant than W. Payment source and transplant donor source did not appear to be significantly different between NA and W. The lower transplant rates in NA versus W in Network No. 15 cannot be explained by age or diagnosis-specific fac tors.