We need more kidneys: Living donation, BMI, and Black mortality from renal disease

Renal disease is an endemic problem within the United States, with about 10% of the population afflicted with kidney problems that range from minor to life-threatening. Black Americans are especially affected by kidney disease, with a high proportion of those affected needing a kidney transplant. While kidney transplants are very common, a shortage of donated kidneys exists, causing many people to turn to directed living donation, through which family members or friends volunteer to donate a healthy kidney to a specific person. This essay examines racial bias in the evaluation of living donors, especially the bias associated with body mass index. The requirement for a “normal weight” prevents many African American volunteers from donating, leading to a higher mortality rate than necessary for Black kidney transplant patients.