Related Experiment Video
Updated: Jun 1, 2026
05:00
Using a Chemical Biopsy for Graft Quality Assessment
Published on: June 17, 2020
Barriers to evaluation and wait listing for kidney transplantation
Jesse D Schold1, Jon A Gregg, Jeffrey S Harman
1Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, USA. scholdj@ccf.org
Summary
Patient income, insurance, and age significantly impact kidney transplant access for end-stage renal disease (ESRD) patients. Addressing these socioeconomic factors is crucial for equitable kidney transplantation.
Area of Science:
- Nephrology
- Transplantation Medicine
- Health Services Research
Background:
- Socioeconomic and demographic factors influence end-stage renal disease (ESRD) patient progression towards kidney transplantation.
- Understanding these factors is vital for improving equitable access to life-saving transplants.
Purpose of the Study:
- To evaluate patient characteristics associated with progression to kidney transplantation.
- To assess the interplay of these factors in a large cohort of referred ESRD patients.
Main Methods:
- Analysis of 3029 adult patients referred for transplantation between 2003 and 2008.
- Utilized logistic regression models to identify factors associated with evaluation, waiting list placement, and transplant receipt.
Main Results:
- Only 17% of referred patients received a kidney transplant; 56% were evaluated, and 27% were placed on the waiting list.
- Older age, lower income, and non-commercial insurance were linked to reduced transplant likelihood.
- Racial disparities in waiting list placement were diminished when accounting for income and insurance status.
Conclusions:
- Age, income, and insurance status are key determinants of kidney transplant access for ESRD patients.
- Disparities in transplant access may be largely driven by socioeconomic factors, particularly insurance coverage, highlighting potential inequities despite Medicare coverage.
Related Concept Videos
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
01:25Chronic Kidney Disease I: Introduction
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...