For a study, researchers sought to assess the prevalence of ACP and PC among adult KT candidates and recipients based on age and race. Through chart review, they analyzed the presence of ACP and PC in 2,579 KT hopefuls and 1,234 KT grantees from 12/2008 to 2/2020. Multivariable logistic regression was used to identify ACP and PC correlations.

The mean ages of KT applicants and recipients were 55 and 53 years old, respectively; 46.6% and 40.5% were Black. ACP was found in 21.4% of candidates, with a greater frequency in older (18-64 years=19.9%, 65+=25.7%) and White applicants (White=24.4%, Black=19.1%, Hispanic=15.0%, other race=21.0%). ACP was found in 34.9% of recipients; similarly, elderly patients (18-64 years=31.7%, 65+=47.1%) and White patients (White=39.5%, Black=31.2%, Hispanic=26.3%, other=26.6%) had a greater prevalence. Only among KT patients were older age (OR=1.85, 95% CI 1.35-2.53) and Black race (OR=0.68, 95% CI 0.51-0.91) linked with ACP after adjustment. PC prevalence was 4.3% in candidates and 5.1% in receivers, with older candidates (18-64 years=3.8%, 65+=5.6%, P=0.046) and recipients (18-64 years=3.8%, 65+=10.0%, P<0.001) having a greater prevalence. Only Black race (OR=0.65, 95% CI 0.42-0.99) was linked with PC in candidates after adjustment, while only greater age (OR=2.47, 95% CI 1.38-4.41) was associated with PC in recipients. When compared to people with chronic illness in the United States, KT candidates and recipients have a reduced prevalence of ACP and PC. Importantly, there were considerable racial and ethnic inequalities in ACP.