For patients with ESKD, there has been little improvement in the rates of waitlist placement or transplantation (WLT) since 1997, according to a study published in the Journal of the American Society of Nephrology. Investigators examined the longitudinal pattern of access to kidney transplantation among patients with ESKD aged 18- 70 from 1997 to 2016 in the United States Renal Data System. Data were included for 1.3 million patients. The 4-year WLT incidence was 29.7%, which was stable over 5 eras from 1997-2000 to 2013-2016. There was an increase seen in preemptive WLT (prior to dialysis) by era, from 5.2% in 1997-2000 to 9.8% in 2013-2016. Four-year WLT incidence increased among patients aged 60 to 70 (13.4% to 19.8%) but decreased among patients aged 18 to 39 (55.8% to 48.8%). Among patients in lower income communities, 4-year WLT incidence was considerably lower, with no improvement over time. The investigators observed a significant decrease over time in the probability of WLT after dialysis (adjusted hazard ratio, 0.80 for 2013-2016 vs 1997-2000).
