{"title":"Experiential Evidence of Systemic Racism for Indigenous Peoples Navigating Transplantation in Canada","authors":"Simone Kennedy , Robyn Wiebe , Reetinder Kaur , Ayumi Sasaki , Adrienne Charlie , Alissa Assu , Allison Jaure , Jagbir Gill","doi":"10.1016/j.ekir.2025.02.027","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Despite previous data stating that Indigenous patients with kidney failure are 66% less likely to receive a kidney transplant compared with White Canadians, there is a very limited understanding of the barriers and challenges experienced and described by Indigenous Peoples when accessing kidney transplantation. The aim of this study was to describe the perspectives and experiences of Indigenous kidney transplant candidates and recipients, living kidney donors, and Elders on access to kidney transplantation in British Columbia, Canada in the hopes of codeveloping and implementing health services interventions to address systemic barriers to transplantation.</div></div><div><h3>Methods</h3><div>Semistructured interviews were conducted with 19 participants and 4 focus groups were conducted with 18 participants (<em>n</em> = 37). Transcripts were thematically analyzed.</div></div><div><h3>Results</h3><div>Five themes were identified as follows: (i) confronting uncertainty and risk, (ii) culture of giving, (iii) systemic racism and discrimination, (iv) navigating complexities of transplant and donation process, and (v) a lack of culturally safe care.</div></div><div><h3>Conclusion</h3><div>These findings highlight that Indigenous patients face potentially modifiable barriers that may be amenable to health system improvements, such as development of culturally safe patient education tools and Indigenous-specific navigation supports. Health services and policy interventions need to be explored and evaluated to begin to address inequities in access to transplantation.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 5","pages":"Pages 1538-1547"},"PeriodicalIF":5.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney International Reports","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468024925001172","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Despite previous data stating that Indigenous patients with kidney failure are 66% less likely to receive a kidney transplant compared with White Canadians, there is a very limited understanding of the barriers and challenges experienced and described by Indigenous Peoples when accessing kidney transplantation. The aim of this study was to describe the perspectives and experiences of Indigenous kidney transplant candidates and recipients, living kidney donors, and Elders on access to kidney transplantation in British Columbia, Canada in the hopes of codeveloping and implementing health services interventions to address systemic barriers to transplantation.
Methods
Semistructured interviews were conducted with 19 participants and 4 focus groups were conducted with 18 participants (n = 37). Transcripts were thematically analyzed.
Results
Five themes were identified as follows: (i) confronting uncertainty and risk, (ii) culture of giving, (iii) systemic racism and discrimination, (iv) navigating complexities of transplant and donation process, and (v) a lack of culturally safe care.
Conclusion
These findings highlight that Indigenous patients face potentially modifiable barriers that may be amenable to health system improvements, such as development of culturally safe patient education tools and Indigenous-specific navigation supports. Health services and policy interventions need to be explored and evaluated to begin to address inequities in access to transplantation.
期刊介绍:
Kidney International Reports, an official journal of the International Society of Nephrology, is a peer-reviewed, open access journal devoted to the publication of leading research and developments related to kidney disease. With the primary aim of contributing to improved care of patients with kidney disease, the journal will publish original clinical and select translational articles and educational content related to the pathogenesis, evaluation and management of acute and chronic kidney disease, end stage renal disease (including transplantation), acid-base, fluid and electrolyte disturbances and hypertension. Of particular interest are submissions related to clinical trials, epidemiology, systematic reviews (including meta-analyses) and outcomes research. The journal will also provide a platform for wider dissemination of national and regional guidelines as well as consensus meeting reports.