Member's paper - Kidney Health Education and Research Group

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Abstract
Tibyan Ahmed1, Sumaya Dano1, Christina Zhou1, Indranie Unarain1, Mohammed Saqib1, Vernon Li1, Ben Khoo1, Marta Novak2, Istvan Mucsi1
2019
American Transplant Congress




Full Abstract
Background: LDKT is the optimal treatment for many patients with End Stage Kidney Disease (ESKD) , offering better clinical outcomes and quality of life. Studies have found that patients with limited social support had lower access to LDKT. However only few studies assessed the association of social support with the various steps during the pursuit of LDKT. Here we assess the association between perceived social support and steps during pursuit of LDKT. Methods: In this cross-sectional convenience sample of adults with ESKD from several dialysis clinics across the Greater Toronto Area, participants completed questionnaires on a tablet-based electronic data capture system. Perceived social support was assessed by a single question ?In the past 6 months, how much help or support related to transplant have you received??. Possible answers were ?none; a little/some; a great deal.? The primary outcome variable was the answer (yes/no) to the question: ?do you have at least one potential donor?? Secondary outcome variable was LDKT readiness: ?how ready are you to pursue living donor kidney transplant,? categorized into ?not considering?, ?considering? and ?taking actions? for LDKT. Sociodemographic and clinical characteristics were also tabulated. Results: The mean age (SD) of the sample (n=262) was 54 (13) years; 66% (157) were male, 59% (139) were married or in common-law relationships, 64% (148) reported having less than 12 years of education. Patients who reported ?a great deal of support? were more likely to have a potential living donor identified (odds ratio [OR]=4.32, 95% confidence interval [CI]= 2.11-8.83 P<0.001) compared to patients who reported receiving no support. The association remained significant after adjusting for age, ethnicity, marital status, income, education and days on dialysis (OR=3.56 CI=1.48-8.58, P=0.005). Additionally, compared to patients who were only ?considering? LDKT, patients were more likely to ?taking action? for LDKT if they reported having received ?a great deal? of support (adjusted relative risk ratio [RRR]= 3.18, CI=1.22-8.25 P=0.018). Conclusion: Patients with more perceived social support are more likely to have a potential donor identified and are more ready to pursue LDKT. Further research should assess if improving interventions social support could facilitate the pursuit of LDKT.

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