HOUSES Index as an Innovative Socioeconomic Measure Predicts Graft Failure Among Kidney Transplant Recipients

Maria A. Stevens, Timothy J. Beebe, Chung II Wi, Sandra J. Taler, Jennifer L. St. Sauver, Young J. Juhn

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


BACKGROUND: Despite extensive evaluation processes to determine candidacy for kidney transplantation, variability in graft failure exists. The role of patient socioeconomic status (SES) in transplantation outcomes is poorly understood because of limitations of conventional SES measures.

METHODS: This population-based retrospective cohort study assessed whether a validated objective and individual-level housing-based SES index (HOUSES) would serve as a predictive tool for graft failure in patients (n = 181) who received a kidney transplant in Olmsted County, MN (January 1, 1998 to December 8, 2016). Associations were assessed between HOUSES (quartiles: Q1 [lowest] to Q4 [highest]) and graft failure until last follow-up date (December 31, 2016) using Cox proportional hazards. The mean age (SD) was 46.1 (17.2) years, 109 (60.2%) were male, 113 (62.4%) received a living kidney donor transplant, and 40 (22.1%) had a graft failure event.

RESULTS: Compared with Q1, patients with higher HOUSES (Q2-Q4) had significantly lower graft failure rates (adjusted hazard ratio, 0.47; 95% confidence interval, 0.24-0.92; P < 0.029), controlling for age, sex, race, previous kidney transplantation, and donor type.

CONCLUSIONS: Although criteria for kidney transplant recipients are selective, patients with higher HOUSES had lower graft failure rates. Thus, HOUSES may enable transplantation programs to identify a target group for improving kidney transplantation outcomes.

Original languageEnglish (US)
Pages (from-to)2383-2392
Number of pages10
Issue number11
StatePublished - Nov 1 2020

Bibliographical note

Funding Information:
ACKNOWLEDGMENTS We thank the Precision Population Science Lab, as well as Lila Rutten, PhD, who helped make this study possible. We also thank Kelly Okeson for her administrative support. In addition, we thank the Rochester Epidemiology Project, supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676, who provided support and resources to make this study possible.

Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.


Dive into the research topics of 'HOUSES Index as an Innovative Socioeconomic Measure Predicts Graft Failure Among Kidney Transplant Recipients'. Together they form a unique fingerprint.

Cite this