Younger Doctors More Likely to Recommend Preemptive Kidney Transplantation

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Recent medical school graduates are more likely than veteran doctors to refer CKD patients for pre-emptive kidney transplantation.
  • Educating veteran referring physicians might increase the number of early referrals.
  • National Kidney Foundation guidelines recommend the promotion of early and pre-emptive kidney transplantation.

Recent medical school graduates are more likely than veteran doctors to refer CKD patients for pre-emptive kidney transplantation, a new study suggests.

Little is known about the characteristics of physicians who refer patients in time for pre-emptive transplantation. Daniela Ladner, MD, and colleagues at Northwestern University in Evanston, Ill., analyzed information on 529 adult patients who received a living donor kidney transplant at their institution between March 2007 and May 2009. Of these, 274 were pre-emptive.

The investigators found that doctors closer to completion of medical school were significantly more likely to refer their patients in time for pre-emptive transplantation. The study suggests that more experienced physicians lack of knowledge about pre-emptive kidney transplantation and that educating veteran referring physicians might increase the number of early referrals.

Advanced CKD patients who undergo pre-emptive transplantation live longer, have better transplanted-kidney function, and enjoy improved quality of life vs. patients who require dialysis prior to transplant.

National Kidney Foundation guidelines recommend the promotion of early and pre-emptive kidney transplantation, though only a fraction of kidney transplants are pre-emptive.

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