Introduction: African Americans and other racially minoritized individuals are affected by chronic stress associated with exposure to racial discrimination, which can adversely impact health. African American children are disproportionately affected by adverse cardiovascular morbidities after kidney transplant. It is important to identify experiences of racism among racially minoritized pediatric patients to better understand how racism contributes to CV health.  The perception of racism among a racially diverse group of pediatric kidney transplant recipients has not been explored.
Methods: Pediatric patients (n= 39, mean age= 15.2 years, 46% female) or their parents presenting to a multidisciplinary pretransplant evaluation clinic were administered the Perceptions of Racism in Children and Youth (PRaCY) questionnaire, a 10-item validated instrument consisting of questions pertaining to situations to assess the severity, frequency and chronicity of racial discrimination experienced by the participants because of the color of their skin, language, accent, culture or country of origin. The PRaCY was completed on an electronic tablet.
Results: Participants were racially diverse- 15 Latinx, 11 African Americans, 6 White, 4 biracial, and 3 Asians. The most frequently endorsed item on the PRaCY was “someone being rude”, followed by “been called an insulting name”; those items were also the two most frequently endorsed ones by African American respondents. Latinx respondents most frequently reported hearing insulting remarks and most biracial respondents noted having seen their family members treated poorly or unfairly.
Conclusion: The findings from this study indicate that a significant number of racially minoritized patients perceive some form of racism, even in their young lives. These experiences may contribute to CV health via alterations in psychological, physiological, and behavioral pathways. It is imperative that the association of these experiences on physiological functioning be explored further to better serve all our patients and implement effective interventions to eliminate racial disparities in outcomes after transplant.