Kidney Transplant Outcomes in Indigenous People of the Northern Great Plains of the United States.

Introduction: Indigenous people experience higher rates of end-stage renal disease as well as negative predictive factors such as medical comorbidities, lower socioeconomic status, greater waitlist time, and fewer pre-emptive transplants that undermine kidney transplantation success. In addition, Indian tribal reservation-dwelling Indigenous people may also be disproportionately affected by poverty, geographical disadvantages, limited physician availability, lower health literacy and cultural beliefs that further reduce access to care. Historically, all racial minority groups have experienced higher rates of rejection events, graft failure and mortality relating to these inequalities.