Minority communities face critical barriers to kidney transplantation, with current wait-list criteria intensifying racial health disparities in the United States. New research presented at Kidney Week highlights that expanding wait-list eligibility to consider a patient’s individual risk for kidney failure—rather than a fixed measurement of kidney function—could transform outcomes.
Scientists analyzed data from a million U.S. veterans and found the standard eGFR threshold of 20 mL/min/1.73m² misses many candidates at high risk, especially among Black, Hispanic, and Asian patients. Using the Kidney Failure Risk Equation (KFRE) as a criterion, researchers saw that more minority patients—including those with diabetes or albuminuria—would gain access to the transplant wait list compared to the current rule.
Crucially, this risk-based approach does not increase death or hospitalization rates, yet it helps even the odds for younger patients and minority groups living with chronic kidney disease. Patients selected by the KFRE were younger and more likely to belong to racial minority populations than those selected by the eGFR standard, which typically includes older patients. Progression to end-stage disease within a year was more common for risk-selected candidates, demonstrating urgent need for prioritized care.
By individualizing eligibility and breaking from a one-size-fits-all standard, experts say this policy shift can actively reduce racial gaps in kidney transplant access. Researchers recommend continued study in broader populations, but early evidence points toward real potential for improving equity and lives.
See: “ASN Expanding Kidney Transplant Wait List Criteria to Include Risk for Kidney Failure Could Improve Outcomes” (November 18, 2025)
