Barriers to kidney transplantation in ESKD

Area of Science:

• Nephrology
• Transplantation Medicine
• Health Services Research

Background:

• Kidney transplantation is the optimal treatment for end-stage kidney disease (ESKD), offering superior survival rates compared to dialysis.
• Despite clear benefits, a significant gap exists between the need for kidney transplants and the number of patients receiving them.
• Minimizing or eliminating time spent on dialysis is a key goal in ESKD management.

Purpose of the Study:

• To identify and categorize barriers hindering kidney transplantation access for ESKD patients.
• To review potential interventions aimed at mitigating these barriers and improving transplant rates.
• To optimize the kidney transplant evaluation process and enhance patient outcomes.

Main Methods:

• This review synthesizes existing literature on barriers to kidney transplantation.
• Barriers are classified into patient-related, physician/provider-related, and system-related categories.
• The analysis considers the multifaceted nature of these barriers across the healthcare system.

Main Results:

• Identified barriers significantly impede access to kidney transplantation for ESKD patients.
• Barriers often overlap and operate at multiple levels within the healthcare system.
• Understanding these barriers is essential for developing targeted interventions.

Conclusions:

• Addressing identified barriers is critical for improving kidney transplant access and patient survival.
• Interventions should focus on mitigating patient, provider, and systemic obstacles.
• Optimizing the transplant evaluation process can lead to better outcomes for ESKD patients.