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Author Notes:

Corresponding author: Nancy G. Kutner, nkutner@emory.edu.

We are grateful for patients' participation in the study and for contributions of the CDS Steering Committee: Glenn M. Chertow, George A. Kaysen, Kirsten L. Johansen and Jordi Goldstein, USRDS Nutrition Special Studies Center; Lawrence Hunsicker, USRDS Economics Special Studies Center; Donna Brogan and Nancy G. Kutner, USRDS Rehabilitation/Quality of Life Special Studies Center; Allan J. Collins, Shu-Cheng Chen and Sarah Pederson, USRDS Coordinating Center; Doug Marsh and Vickie Peters, ESRD Network Coordinating Center; Sondra Frenz, DataBanque Research Services; Lawrence Y. Agodoa and Paul W. Eggers, NIDDK; Pam Frederick and Condict Martak, CMS.

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.


Research Funding:

This study was supported by National Institutes of Health contract HHSN267200715004C, ADB No. N01-DK-7-5004 (Dr. Kutner).

The interpretation and reporting of the data presented here are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Surgery
  • Transplantation
  • Access to transplantation
  • African Americans
  • kidney transplantation
  • patient education
  • United States Renal Data System
  • waiting list

Perspectives on the New Kidney Disease Education Benefit: Early Awareness, Race and Kidney Transplant Access in a USRDS Study


Journal Title:

American Journal of Transplantation


Volume 12, Number 4


, Pages 1017-1023

Type of Work:

Article | Post-print: After Peer Review


Education services for Stage-IV chronic kidney disease patients were added in 2010 as a Part B covered benefit under the Medicare Improvements for Patients and Providers Act. Desired outcomes include early pursuit of kidney transplantation by more patients and reduction of racial disparities in access to transplantation. During 2005-2007, a United States Renal Data System (USRDS) special study surveyed 1123 patients in a national cohort who had recently started dialysis, identified themselves as black or white, and were reported by their physician as potentially eligible transplant candidates. Patients were asked if kidney transplantation had been discussed with them before they initiated renal replacement therapy, and survey responses were linked with subsequent wait listing and transplant events in USRDS registry files. Kaplan-Meier analyses showed a significant association between early transplant awareness and subsequent wait listing. Adjusted Cox models showed a significant race/early transplant awareness interaction, however, with the impact of early awareness on wait listing much stronger for whites. Ongoing support and education about kidney transplantation for patients after dialysis start could help to build on early education and foster greater quality improvement in patient outcomes.

Copyright information:

© 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

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