Factors affecting willingness to receive a kidney transplant among minority patients at an urban safety-net hospital: a cross-sectional survey

• Type of Material: Article
• Authors: Titilayo Ilori, Emory University; Nosayaba Enofe, Emory University; Anju Oommen, Emory University; Oluwaseun Odewole, Emory University; Akinlolu Ojo, University of Michigan; Laura Plantinga, Emory University; Stephen Pastan, Emory University; Justin B. Echouffo-Tcheugui, Emory University; William McClellan, Emory University
• Language: English
• Date: 2015-11-21
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Ilori et al. 2015
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12882-015-0186-2
• Title of Journal or Parent Work: BMC Nephrology
• ISSN: 1471-2369
• Volume: 16
• Issue: 1
• Start Page: 191
• End Page: 191
• Grant/Funding Information: TOI receives educational support from the ACTSI.; This study was supported in part from divisional funds of the Department of Nephrology, Emory University Atlanta GA.; This work was supported in part by Health Resources and Services Administration contract 234-2005-370011C.; This publication was also supported in part by the National Heart, Lung, Blood and Sleep Institute, National Institutes of Health, through Grant Number R25 HL105401.
• Keywords: RACIAL DISPARITIES; RACE; ACCESS; HEMODIALYSIS-PATIENTS; UNITED-STATES; Science & Technology; DISEASE; Kidney transplant; Life Sciences & Biomedicine; Knowledge; Urology & Nephrology; Willingness; Perceptions; SOCIODEMOGRAPHIC FACTORS; Attitudes; BARRIERS; CADAVERIC RENAL-TRANSPLANTATION; DONOR; African Americans; CKD
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Background: In the US, African Americans (AAs) are four times more likely to develop end stage renal disease (ESRD) but half as likely to receive a kidney transplant as whites. Patient interest in kidney transplantation is a fundamental step in the kidney transplant referral process. Our aim was to determine the factors associated with the willingness to receive a kidney transplant among chronic kidney disease (CKD) patients in a predominantly minority population. Methods: CKD patients from an outpatient nephrology clinic at a safety-net hospital (n = 213) participated in a cross-sectional survey from April to June, 2013 to examine the factors associated with willingness to receive a kidney transplant among a predominantly minority population. The study questionnaire was developed from previously published literature. Multivariable logistic regression analysis was used to determine factors associated with willingness to undergo a kidney transplant. Results: Respondents were primarily AAs (91.0 %), mostly female (57.6 %) and middle aged (51.6 %). Overall, 53.9 % of participants were willing to undergo a kidney transplant. Willingness to undergo a kidney transplant was associated with a positive perception towards living kidney donation (OR 7.31, 95 % CI: 1.31-40.88), willingness to attend a class about kidney transplant (OR = 7.15, CI: 1.76-29.05), perception that a kidney transplant will improve quality of life compared to dialysis (OR = 5.40, 95 % CI: 1.97-14.81), and obtaining information on kidney transplant from other sources vs. participant's physician (OR =3.30, 95 % CI: 1.13-9.67), when compared with their reference groups. Conclusion: It is essential that the quality of life benefits of kidney transplantation be known to individuals with CKD to increase their willingness to undergo kidney transplantation. Availability of multiple sources of information and classes on kidney transplantation may also contribute to willingness to undergo kidney transplantation, especially among AAs.