title: Factors affecting willingness to receive a kidney transplant among minority patients at an urban safety-net hospital: a cross-sectional survey.
abstract: BACKGROUND
  In the US, African Americans (AAs) are four times more likely to develop end stage renal disease (ESRD) but half as likely to receive a kidney transplant as whites. Patient interest in kidney transplantation is a fundamental step in the kidney transplant referral process. Our aim was to determine the factors associated with the willingness to receive a kidney transplant among chronic kidney disease (CKD) patients in a predominantly minority population.
  
  
  METHODS
  CKD patients from an outpatient nephrology clinic at a safety-net hospital (n = 213) participated in a cross-sectional survey from April to June, 2013 to examine the factors associated with willingness to receive a kidney transplant among a predominantly minority population. The study questionnaire was developed from previously published literature. Multivariable logistic regression analysis was used to determine factors associated with willingness to undergo a kidney transplant.
  
  
  RESULTS
  Respondents were primarily AAs (91.0%), mostly female (57.6%) and middle aged (51.6%). Overall, 53.9% of participants were willing to undergo a kidney transplant. Willingness to undergo a kidney transplant was associated with a positive perception towards living kidney donation (OR 7.31, 95% CI: 1.31-40.88), willingness to attend a class about kidney transplant (OR = 7.15, CI: 1.76-29.05), perception that a kidney transplant will improve quality of life compared to dialysis (OR = 5.40, 95% CI: 1.97-14.81), and obtaining information on kidney transplant from other sources vs. participant's physician (OR =3.30, 95% CI: 1.13-9.67), when compared with their reference groups.
  
  
  CONCLUSIONS
  It is essential that the quality of life benefits of kidney transplantation be known to individuals with CKD to increase their willingness to undergo kidney transplantation. Availability of multiple sources of information and classes on kidney transplantation may also contribute to willingness to undergo kidney transplantation, especially among AAs.
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. tilori@emory.edu.|Renal Division, Emory University School of Medicine, 1639 Pierce Drive, Atlanta GA. Clifton Road, Atlanta, Georgia, 30322, USA. tilori@emory.edu.
authors.forename: Titilayo O
authors.initials: TO
authors.lastname: Ilori
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. nenofe@emory.edu.
authors.forename: Nosayaba
authors.initials: N
authors.lastname: Enofe
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. anju.oommen@emory.edu.
authors.forename: Anju
authors.initials: A
authors.lastname: Oommen
authors.affiliation: Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Georgia, USA. oodewol@emory.edu.
authors.forename: Oluwaseun
authors.initials: O
authors.lastname: Odewole
authors.affiliation: Department of Medicine, Renal Division, University of Michigan, Ann Arbor, Michigan, USA. aojo@umich.edu.
authors.forename: Akinlolu
authors.initials: A
authors.lastname: Ojo
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. laura.plantinga@emory.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Plantinga
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. Stephen.Pastan@emoryhealthcare.org.|Emory Transplant Center, Emory Healthcare, Atlanta, Georgia, USA. Stephen.Pastan@emoryhealthcare.org.
authors.forename: Stephen
authors.initials: S
authors.lastname: Pastan
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. jechouf@emory.edu.|MedStar Health, Baltimore, Maryland, USA. jechouf@emory.edu.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Echouffo-Tcheugui
authors.affiliation: Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. wmcclel@emory.edu.|Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. wmcclel@emory.edu.
authors.forename: William
authors.initials: W
authors.lastname: McClellan
mesh_terms: D000293:Adolescent; D001741:Black or African American; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006786:Hospitals, Urban; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D064876:Safety-net Providers; D011795:Surveys and Questionnaires