New research reveals stark racial and ethnic inequities in kidney failure treatment, with the most troubling disparities emerging among younger adults. A sequence analysis of more than 50,000 patients tracked over 10 years shows dramatic differences in who receives life-saving transplants and who dies while on dialysis.
Black patients aged 18 to 44 faced the bleakest outcomes. By month 120, cumulative mortality reached 42.8% for Black patients compared to 23.2% for Asian Americans. Among those still living, only 4.3% of Black patients had functioning living donor kidney transplants versus 21.3% of white patients.
“While the USRDS annual data report provides statistics by race/ethnicity or age separately, it lacks statistics on their interaction,” wrote study investigator Jonathan Daw, an associate professor at Pennsylvania State University. His team found that racial and ethnic groups vary significantly in their age patterns of kidney replacement therapy, “which could imply critical periods for antidisparity interventions.”
The disparities extend beyond mortality. Living donor transplants remained consistently most common among white patients and least common among Black patients throughout the decade. At treatment initiation, 8.7% of white patients received living donor transplants compared to just 1.4% of Black patients.
For young Black adults, the most common treatment path was in-center dialysis followed by death, occurring in 31.6% of cases. These patterns reflect systemic and social influences that limit access to preferred treatments like home dialysis and transplantation for minority communities.
See: “Younger Adults Face Pronounced Racial, Ethnic Gaps in Kidney Therapy” (January 15, 2026)
