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Survey Probes Barriers to Living Donor Kidney Transplantation

Twenty million American adults have some degree of chronic kidney disease. The most serious form of chronic kidney disease is end-stage renal disease, which develops when total and permanent kidney failure occurs, causing the body to retain fluid and harmful waste.

For most end-stage renal disease patients, living donor kidney transplantation (LDKT) is the treatment of choice. Yet, racial disparities in kidney transplantation persist. In particular, African-Americans have the lowest rate of LDKT among all racial groups even though they have three times the rate of end-stage renal disease than whites.

An article, published in the Journal of Health Care for the Poor and Underserved, used survey methods to probe the barriers to LDKT among African-American adults receiving hemodialysis treatment at two Philadelphia outpatient clinics. In the survey, 101 African-American patients were administered the Temple University Hospital Dialysis Patient Questionnaire co-developed by Temple University researchers and Heather Hammer, Abt SRBI Group Vice President of Health.

The article, co-authored by Hammer, finds that:
  • Most patients (72.3 percent) were interested in LDKT;
  • But only 34.2 percent had asked someone for a donation; and
  • About half (49.5 percent) had an unsolicited offer, regardless of whether they asked.
Major barriers to asking for a donation included:
  • Feelings of guilt (56.3 percent);
  • Fear (37.2 percent);
  • Concerns about the donor (33.3 percent);
  • Reluctance to ask a potential donor for a kidney (28.1 percent); and
  • Concerns about their own health (24.6 percent).
The survey results suggest that interventions should focus on overcoming reluctance to ask for a kidney donation or to accept unsolicited offers.
North America
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