NDT Advance Access originally published online on January 7, 2009
Nephrology Dialysis Transplantation 2009 24(4):1298-1305; doi:10.1093/ndt/gfn733
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Haemodialysis patients’ readiness to pursue live donor kidney transplantation
1 Department of Pharmaceutical Health Services Research, University of Maryland 2 Independent Dialysis Foundation 3 Department of Surgery, University of Maryland, Baltimore, MD, USA
Correspondence and offprint requests to: Françoise G. Pradel, Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, 220 Arch Street, Office level one, Baltimore, MD 21201, USA. Tel: +1-410-706-4044; Fax: +1-410-706-5394; E-mail: fpradel{at}rx.umaryland.edu
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Abstract |
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Background. Despite the benefits of live donor kidney transplantation (LDKT) over deceased donor kidney transplantation, patients hesitate to pursue this option.
Methods. A total of 324 transplant-eligible haemodialysis patients attending 14 dialysis facilities in Maryland, Northern Virginia and Southern Pennsylvania were asked about their stages of readiness to pursue LDKT, attitudes towards LKDT and demographics. Logistic regressions were used to test the effect of patients’ attitudes and demographics on their stages of readiness to pursue LDKT.
Results. Fewer than half of the patients who had heard about LDKT were considering this option. Among patients considering LDKT, 26% had not talked to their loved ones about LDKT and 54% had not asked anyone for a kidney. Concerns about the surgical procedure for the donor were associated with a lower likelihood of considering LDKT (adjusted OR = 0.38; CI 0.18–0.79), talking about LDKT (adjusted OR = 0.38; CI 0.18–0.78) and asking for a kidney (adjusted OR = 0.14; CI 0.06–0.36). Being satisfied with the information the patient received about LDKT was associated with a higher likelihood of talking with someone about LDKT and asking for a kidney (adjusted OR = 2.26; CI 1.33–3.83 and 3.89; CI 1.78–8.51). Women and younger patients were more likely to talk with family/friends about LDKT (respectively, adjusted OR = 1.76; CI 1.26–2.47 and 0.97; CI 0.95–0.99) and to ask for a kidney (respectively, adjusted OR = 4.36; CI 2.57–7.40 and 0.97; CI 0.94–0.99).
Conclusion. Tailored educational programmes considering the patient's stage of readiness and related attitudinal and demographic factors might help patients move towards LDKT.
Keywords: attitude; decision making; kidney transplantation; living donor; recipient
Received for publication: 28. 5.08
Accepted in revised form: 8.12.08