Few Referrals for Transplant Evaluation Among Dialysis Patients

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Findings among end-stage renal disease patients initiating dialysis in Georgia.
Findings among end-stage renal disease patients initiating dialysis in Georgia.

(HealthDay News) -- Few new end-stage renal disease (ESRD) patients are referred for kidney transplant evaluation within one year of starting treatment, although referral practices vary considerably, according to a study published in the Journal of the American Medical Association.

Rachel E. Patzer, Ph.D., M.P.H., from the Emory University School of Medicine in Atlanta, and colleagues assessed variation in dialysis facility referral for kidney transplant evaluation among 308 Georgia dialysis facilities (15,279 incident, adult patients with ESRD) from January 2005 to September 2011, with follow up through September 2012. Referral data were linked to transplant center data.

The researchers found that the median within-facility percentage of patients referred within one year of starting dialysis was 24.4%, and varied from 0 to 75%. Compared with facilities in the highest tertile of referral (>31.3%), facilities in the lowest tertile of referral (<19.2%) were more likely to treat patients living in high-poverty neighborhoods, had a higher patient-to-social worker ratio, and were more likely nonprofit.

"Variables associated with referral were not always associated with waitlisting, suggesting that different factors may account for disparities in referral," the authors write.

One author disclosed financial ties to a dialysis center.

Sources

  1. Patzer, RE; Plantinga, LC; Paul, S; et al. JAMA 2015;314(6):582-594; doi:10.1001/jama.2015.8897.
  2. Kucirka, LM; Purnell, TS; and Segev, DL. JAMA 2015;314(6):565-567; doi:10.1001/jama.2015.8932.
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