Knowledge about Benefits of Kidney Transplantation: A Survey of Dialysis Patients

Background: Knowledge about benefits of kidney transplantation (KT) is an important determinant of the patients’ decision to pursue KT. We investigated factors associated with End Stage Renal Disease (ESRD) patients’ knowledge about KT benefits.

Methods: We randomly invited 1,400 dialysis patients to complete a survey about benefits of KT. Using multivariate analysis, we calculated odds ratios for the probability of choosing the correct responses.

Results: Of 673 participants, 17.6% agreed with benefit of KT for older patients, 36.5% agreed with benefit of KT for diabetic patients, and 31.5% agreed with benefit of pre-emptive KT. Non-white (OR: 0.68) and older (OR: 0.65) participants were less likely to agree with the survival benefit of KT. Older participants were less likely to agree with benefit of KT for older (OR: 0.64), and diabetic patients (OR: 0.54). Participants with less than high school education were less likely to agree with benefit of pre-emptive KT (OR: 0.58). Participants with a previous KT were more likely to agree with benefit of KT for older (OR: 2.32), and diabetic patients (OR: 2.50), and with the benefit of pre-emptive KT (OR: 2.34). Participants who had received 3 or more modes of education about KT were more likely to agree with benefit of KT for diabetic patients (OR: 2.04), and with benefit of pre-emptive KT (OR:1.67).

Conclusions: Dialysis patients have limited knowledge about benefits of KT. Previous KT, exposure to 3 or more modes of KT education, and education attainment are significant contributors to knowledge about KT benefits.

What is already known about this subject

• The quality and frequency of education patients receive about kidney transplantation (KT) has a significant effect in the patients’ decision to pursue KT.

• Lack of understanding of the benefits of KT can lead to patients having negative perceptions and views about KT.

• Patients who have been educated about the benefits are less likely to deny KT.

What this study adds

• Among patients with ESRD, overall knowledge of the survival benefits of KT compared with dialysis is limited.

• The lack of knowledge is more salient among non-white patients, those with less than a high school education, and those older than 60 years of age.

• Receiving multiple modes of education about KT is associated with improved knowledge about the benefits of KT.

Impact on practice or policy

• Multi-modal educational programs especially targeting minority and older populations can lead to increased knowledge and ultimately pursuit of KT.

Keywords:Dialysis; Education; Knowledge; Nephrologists; Transplantation; Chronic kidney disease