Actual and perceived knowledge of kidney transplantation and the pursuit of a live donor.
BACKGROUND
Live donor kidney transplantation (LDKT) remains underutilized, partly resulting from the challenges many patients face in asking someone to donate. Actual and perceived kidney transplantation (KT) knowledge are potentially modifiable factors that may influence this process. Therefore, we sought to explore the relationships between these constructs and the pursuit of LDKT.


METHODS
We conducted a cross-sectional survey of transplant candidates at our center to assess actual KT knowledge (5-point assessment) and perceived KT knowledge (5-point Likert scale, collapsed empirically to 4 points); we also asked candidates if they had previously asked someone to donate. Associations between participant characteristics and having asked someone to donate were quantified using modified Poisson regression.


RESULTS
Of 307 participants, 45.4% were female, 56.4% were non-white race, and 44.6% had previously asked someone to donate. In an adjusted model that included both actual and perceived knowledge, each unit increase in perceived knowledge was associated with 1.21-fold (95% CI: 1.03-1.43, P=0.02) higher likelihood of having asked someone to donate, whereas there was no statistically significant association with actual knowledge (RR=1.08 per unit increase, 95% CI: 0.99-1.18, P=0.10). A conditional forest analysis confirmed the importance of perceived but not actual knowledge in predicting the outcome.


CONCLUSIONS
Our results suggest that perceived KT knowledge is more important to a patient's pursuit of LDKT than actual knowledge. Educational interventions that seek to increase patient KT knowledge should also focus on increasing confidence about this knowledge.
1 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 2 Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD. 3 Johns Hopkins Center on Aging and Health, Baltimore, MD. 4 Department of Nephrology, University of Pennsylvania School of Medicine, Philadelphia, PA. 5 Address correspondence to: Dorry Segev, M.D., Ph.D., Johns Hopkins Medical Institutions, 720 Rutland Avenue, Turner 34A, Baltimore, MD 21205.
Natasha
N
Gupta
Megan L
ML
Salter
Jacqueline M
JM
Garonzik-Wang
Peter P
PP
Reese
Corey E
CE
Wickliffe
Nabil N
NN
Dagher
Niraj M
NM
Desai
Dorry L
DL
Segev
D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D016012:Poisson Distribution; D006435:Renal Dialysis; D016896:Treatment Outcome