African-Canadians with End-Stage Kidney Disease (ESKD) are less likely to receive Living Donor Kidney Transplant (LDKT) compared to Caucasians. When planning interventions to increase LDKT, it is important to understand what actions patients are willing take that are associated with an increased chance of identifying Potential Living Donors (PLD). We explored if African-Canadian patients are less likely to take certain actions to pursue LDKT compared to Caucasian patients.
Cross-sectional, convenience sample of adult patients with end-stage kidney disease from several hospitals in Toronto, Ontario. An electronic data capture system was used to assess transplant related knowledge, if participants took various steps towards pursuing LDKT and if they had a PLD. Clinical information was abstracted from medical records. Non-English-speaking patients and patients unwilling to consent were excluded. Logistic regression analysis was used to analyze the association between taking steps and identifying a PLD.
424 patients were recruited: mean (SD) age 57 (13) years, 62% (263) male and 29% (123) African-Canadian. Compared to Caucasians, African-Canadian patients were less likely to engage in speaking to their families and friends about LDKT (OR=0.26, CI:0.15-0.46, p=<0.001). Additionally, they were less likely to share education materials compared to Caucasians (OR=0.32, CI:0.18-0.60, P=0.013). These relationships remained significant in multivariable logistic regression models adjusting for age, sex, education, marital status and income. African-Canadians were also less likely to report having identified a potential living donor (OR=0.40, CI: 0.21-0.76, P=0.005).
African-Canadian patients are more reluctant to take specific actions, such as speaking to their family and friends about LDKT and sharing educational material with them compared to Caucasians. They are also less likely to have a potential living donor identified compared to Caucasian patients. Further research is needed to better understand the barriers African-Canadians face to pursue LDKT.