People with sickle cell disease are less likely to get kidney transplants than those without

Sickle cell disease predominantly affects Black populations, and kidney transplants can save their lives

sickle cell blood cells under the microscope against a white background

Keith Chambers via Wikimedia Commons (CC BY-SA 3.0

People with sickle cell disease encounter significant health issues such as kidney failure. Sickle cell disease, found predominantly in Black and African American populations, is when red blood cells are shaped like crescent moons (or “sickle-shaped”) instead of round and disc-like. This shape, which may have had evolutionary benefits during previous generations, can block blood flow, and therefore oxygen transport, through a person's body. 

Kidney failure is a major health complication encountered by people with sickle cell disease. Therefore, people with sickle cell disease are often reliant on dialysis treatment to filter the waste from their blood, but this is often not enough to save their lives. 

Therefore, researchers are exploring kidney transplantation as an additional treatment option for patients. In a study published in the Clinical Journal of the American Society of Nephrology, researchers used two national databases that collected information on adults from 1998-2017 with kidney failure who were on dialysis or the kidney transplant list. The researchers measured the impact of kidney transplantation on mortality, as well as differences in access to kidney transplants between people with and without sickle cell disease. 

People with sickle cell disease who were on dialysis had a higher mortality risk than the control group. However, the researchers found that transplantation reduced mortality risk for people with sickle cell disease as well as those without it, a benefit that lasted for at least ten years. 

Finally, the researchers found that patients with sickle cell were less likely to receive a transplant when compared to the control group, even though kidney transplantation has a higher likelihood of increasing the lifespan of sickle cell patients than does dialysis. This is yet another example of health inequity for Black and African American populations, and one with serious consequences, since kidney transplant is a life-saving intervention for people with sickle cell disease.