{"id":"https://openalex.org/W4416708014","doi":"https://doi.org/10.1681/asn.2025kw1dtjfk","title":"Mortality by Rurality Among Kidney Transplant Recipients in the United States over 20 Years","display_name":"Mortality by Rurality Among Kidney Transplant Recipients in the United States over 20 Years","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4416708014","doi":"https://doi.org/10.1681/asn.2025kw1dtjfk"},"language":"en","primary_location":{"id":"doi:10.1681/asn.2025kw1dtjfk","doi":"https://doi.org/10.1681/asn.2025kw1dtjfk","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025kw1dtjfk","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5072111721","display_name":"Fawaz Al Ammary","orcid":"https://orcid.org/0000-0003-0928-2860","observed_orcids":["https://orcid.org/0000-0003-0928-2860"]},"institutions":[{"id":"https://openalex.org/I204250578","display_name":"University of California, Irvine","ror":"https://ror.org/04gyf1771","country_code":"US","type":"education","lineage":["https://openalex.org/I204250578"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Fawaz Al Ammary","raw_affiliation_strings":["University of California Irvine, Irvine, California, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California Irvine, Irvine, California, United States;","institution_ids":["https://openalex.org/I204250578"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5055190953","display_name":"Elaine Ku","orcid":"https://orcid.org/0000-0002-7774-2526","observed_orcids":["https://orcid.org/0000-0002-7774-2526"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Elaine Ku","raw_affiliation_strings":["University of California San Francisco, San Francisco, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California San Francisco, San Francisco, California, United States","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031580643","display_name":"Andrew D. Rule","orcid":"https://orcid.org/0000-0003-0338-7784","observed_orcids":["https://orcid.org/0000-0003-0338-7784"]},"institutions":[{"id":"https://openalex.org/I1330342723","display_name":"Mayo Clinic","ror":"https://ror.org/02qp3tb03","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrew D. Rule","raw_affiliation_strings":["Mayo Clinic Minnesota, Rochester, Minnesota, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mayo Clinic Minnesota, Rochester, Minnesota, United States;","institution_ids":["https://openalex.org/I1330342723"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027160799","display_name":"Karen D. Lincoln","orcid":"https://orcid.org/0000-0003-1891-2035","observed_orcids":["https://orcid.org/0000-0003-1891-2035"]},"institutions":[{"id":"https://openalex.org/I204250578","display_name":"University of California, Irvine","ror":"https://ror.org/04gyf1771","country_code":"US","type":"education","lineage":["https://openalex.org/I204250578"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Karen D Lincoln","raw_affiliation_strings":["University of California Irvine, Irvine, California, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California Irvine, Irvine, California, United States;","institution_ids":["https://openalex.org/I204250578"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5077412514","display_name":"Simeon Adeyemo","orcid":"https://orcid.org/0009-0008-6495-4600","observed_orcids":["https://orcid.org/0009-0008-6495-4600"]},"institutions":[{"id":"https://openalex.org/I204250578","display_name":"University of California, Irvine","ror":"https://ror.org/04gyf1771","country_code":"US","type":"education","lineage":["https://openalex.org/I204250578"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Simeon Adeyemo","raw_affiliation_strings":["University of California Irvine, Irvine, California, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California Irvine, Irvine, California, United States;","institution_ids":["https://openalex.org/I204250578"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.54475351,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10373","display_name":"Renal Transplantation Outcomes and Treatments","score":0.9336000084877014,"subfield":{"id":"https://openalex.org/subfields/2747","display_name":"Transplantation"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10373","display_name":"Renal Transplantation Outcomes and Treatments","score":0.9336000084877014,"subfield":{"id":"https://openalex.org/subfields/2747","display_name":"Transplantation"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11163","display_name":"Organ Donation and Transplantation","score":0.025299999862909317,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10291","display_name":"Dialysis and Renal Disease Management","score":0.007600000128149986,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/kidney-transplantation","display_name":"kidney transplantation","score":0.9890000224113464},{"id":"https://openalex.org/keywords/rural-residence","display_name":"rural residence","score":0.6420000195503235},{"id":"https://openalex.org/keywords/rurality","display_name":"rurality","score":0.7329999804496765},{"id":"https://openalex.org/keywords/post-transplant-mortality","display_name":"post-transplant mortality","score":0.8709999918937683},{"id":"https://openalex.org/keywords/long-term-transplant-outcomes","display_name":"long-term transplant outcomes","score":0.6290000081062317},{"id":"https://openalex.org/keywords/health-care-access","display_name":"health care access","score":0.8069999814033508},{"id":"https://openalex.org/keywords/end-stage-renal-disease","display_name":"end-stage renal disease","score":0.8240000009536743},{"id":"https://openalex.org/keywords/urban-rural-differences","display_name":"urban-rural differences","score":0.6909999847412109},{"id":"https://openalex.org/keywords/post-transplant-care","display_name":"post-transplant care","score":0.7120000123977661}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8675000071525574},{"id":"https://openalex.org/C2779465365","wikidata":"https://www.wikidata.org/wiki/Q7380600","display_name":"Rurality","level":3,"score":0.7983999848365784},{"id":"https://openalex.org/C2994498544","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Kidney transplant","level":4,"score":0.5400000214576721},{"id":"https://openalex.org/C2780303639","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Kidney transplantation","level":3,"score":0.46540001034736633},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.4291999936103821},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.3912999927997589},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.3621000051498413},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.34769999980926514},{"id":"https://openalex.org/C54847362","wikidata":"https://www.wikidata.org/wiki/Q177635","display_name":"Nephrology","level":2,"score":0.33059999346733093},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3303999900817871},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3190999925136566},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3156000077724457},{"id":"https://openalex.org/C2992666275","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Renal transplant","level":3,"score":0.3077000081539154},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.30649998784065247},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2957000136375427},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2955999970436096},{"id":"https://openalex.org/C2911091166","wikidata":"https://www.wikidata.org/wiki/Q106419912","display_name":"Transplantation","level":2,"score":0.2856000065803528},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2736000120639801},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.25940001010894775},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.2572999894618988},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2535000145435333}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.2025kw1dtjfk","doi":"https://doi.org/10.1681/asn.2025kw1dtjfk","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025kw1dtjfk","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0},{"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities","score":0.7307999730110168}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7165388940","https://openalex.org/W7125707065","https://openalex.org/W2772471931","https://openalex.org/W1574741205","https://openalex.org/W2139434246","https://openalex.org/W2095319635","https://openalex.org/W2805645289","https://openalex.org/W4387115822","https://openalex.org/W7099157287","https://openalex.org/W2071381804"],"abstract_inverted_index":{"Background:":[0],"Kidney":[1],"transplantation":[2],"is":[3],"optimal":[4],"for":[5,237,245],"most":[6],"patients":[7,33],"with":[8,139,197],"end-stage":[9],"kidney":[10,49,73,218],"disease,":[11],"offering":[12],"superior":[13],"survival":[14],"compared":[15,181,204],"to":[16,29,40,57,182,205,240],"dialysis.":[17],"Recipients":[18,108],"require":[19],"lifelong":[20],"immunosuppression":[21],"and":[22,37,81,135,158,170,176,185],"management":[23],"of":[24,69,89,114,202],"chronic":[25],"comorbidities,":[26],"making":[27],"access":[28],"care":[30,60,244],"essential.":[31],"Rural":[32,217],"may":[34],"face":[35],"geographic":[36],"provider-related":[38],"barriers":[39],"quality":[41],"long-term":[42,226,242],"care.":[43],"This":[44],"study":[45,68],"examined":[46],"mortality":[47,166,203,227],"among":[48,155,162,178,187],"transplant":[50,74,115,219],"recipients":[51,75,220],"by":[52],"rural":[53,156,188,193,246],"versus":[54],"non-rural":[55,163,179,206,230],"residence":[56,95,194,207],"inform":[58],"future":[59],"strategies.":[61],"Methods:":[62],"We":[63],"conducted":[64],"a":[65,198],"retrospective":[66],"cohort":[67],"370,937":[70],"adult":[71],"first-time":[72],"in":[76,221],"the":[77,86,112,222,235],"U.S.":[78,223],"between":[79],"1/1/2000,":[80],"12/31/2024,":[82,125],"using":[83,132],"data":[84],"from":[85,111],"Scientific":[87],"Registry":[88],"Transplant":[90],"Recipients.":[91],"The":[92,103,146],"exposure":[93],"was":[94,106,130,150,173,195],"rurality,":[96],"as":[97],"per":[98],"Rural-Urban":[99],"Commuting":[100],"Area":[101],"codes.":[102],"primary":[104],"outcome":[105],"mortality.":[107],"were":[109,137],"followed":[110],"date":[113],"until":[116],"death,":[117],"20":[118],"years":[119,152,154,160],"post-transplant,":[120],"or":[121],"administrative":[122],"censoring":[123],"on":[124],"whichever":[126],"came":[127],"first.":[128],"Mortality":[129],"estimated":[131],"Kaplan-Meier":[133],"curves,":[134],"associations":[136],"assessed":[138],"multivariable":[140],"Cox":[141],"proportional":[142],"hazards":[143],"models.":[144],"Results:":[145],"median":[147],"[IQR]":[148],"age":[149],"54":[151],"[43\u201363]":[153],"recipients,":[157,180],"53":[159],"[42-63]":[161],"recipients.":[164,189],"Estimated":[165],"at":[167],"5,":[168],"10,":[169],"20-years":[171],"post-transplant":[172,243],"13%,":[174],"31%,":[175],"60%":[177],"15%,":[183],"35%,":[184],"67%":[186],"In":[190],"adjusted":[191],"models,":[192],"associated":[196],"10%":[199],"higher":[200,225],"risk":[201],"(adjusted":[208],"hazard":[209],"ratio":[210],"=":[211],"1.10;":[212],"95%":[213],"CI,":[214],"1.08\u20131.11).":[215],"Conclusion:":[216],"experience":[224],"than":[228],"their":[229],"counterparts.":[231],"These":[232],"findings":[233],"underscore":[234],"need":[236],"targeted":[238],"programs":[239],"improve":[241],"patients.":[247],"Funding:":[248],"NIDDK":[249],"Support":[250]},"counts_by_year":[],"updated_date":"2026-10-01T08:54:57.152042","created_date":"2025-11-27T00:00:00"}