Lower rates of kidney transplant referrals at nonprofit dialysis facilities


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New research indicates that patients with kidney failure who receive care in for-profit dialysis centers are less likely to be referred for kidney transplants than those who receive care in non-profit centers. The findings will appear in an upcoming issue of CLAR.

Kidney transplantation is the optimal therapy for most patients with failure. Many patients initiate dialysis for the first time and kidney specialists refer them to a transplant through dialysis facilities. Previous studies have reported that patients treated in for-profit dialysis centers are less likely than those treated in non-profit centers to move to a transplant waiting list and receive a transplant. However, little information is available on the previous steps of the process, i.e., references and medical evaluations for the transplant.

To investigate, a team led by Rachel E. Patzer, Ph.D. and Laura J. McPherson, MPH (Emory University), examined referral and evaluation data from the 9 transplant centers in the southeastern United States (Georgia, North Carolina, and South Carolina), as well as information from the kidney data from the United States.

The analysis included 33,651 patients with kidney failure who started dialysis in the southeast from 2012 to 2016. Eighty-five percent of patients received dialysis treatments in for-profit settings and 15% were treated. in non-profit establishments. A total of 44% of patients were referred for transplantation during the 4-year study period. After adjustments, patients with for-profit facilities were 16% less likely to receive a referral than patients with non-profit facilities. The rates of initiation of medical evaluations at 6 months of referral and the position of patients on a waiting list at 6 months of evaluations did not differ significantly between groups.

“Our study provides information on practice patterns related to referral for transplantation, the start of transplant evaluation at the transplant center, and placement on the national waiting list of deceased donors, but the our study does not have detailed information on the mechanisms and reasons for these transplants differences in referral between non-profit and non-profit facilities, ”said Drs. Patzer. “The reasons for these differences in referral could be due to differences in patients” which are not measured in our dataset, or could be due to other unmeasured factors, such as limited time to educate or refer patients for transplant or unconscious bias. Future research is still needed to better understand these mechanisms, such as through focus groups and interviews with patients and members of the provider team. ”

An accompanying editorial notes that “the first steps for access remains frustratingly opaque, indicating the continuing need to address long-standing disparities and ensure fairness in treatment options for patients with . ”

The likelihood of transplantation is lower in benefit-oriented dialysis facilities

More information:
“Benefit Status of Dialysis Facilities and First Steps in Kidney Transplant in the Southeastern United States” CLAR, DOI: 10.2215 / CJN.17691120

Citation: Lower rates of kidney transplant referrals to nonprofit dialysis facilities (2021, May 26) recovered on May 26, 2021 at https://medicalxpress.com/news/2021-05-kidney -transplant-referrals-for- non-profit.html

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