Decision Aids to Increase Living Donor Kidney Transplantation

AbstractPurpose of ReviewFor the more than 636,000 adults with end-stage renal disease (ESRD) in the USA, kidney transplantation is the preferred treatment compared to dialysis. Living donor kidney transplantation (LDKT) comprised 31% of kidney transplantations in 2015, an 8% decrease since 2004. We aimed to summarize the current literature on decision aids that could be used to improve LDKT rates.Recent FindingsDecision aids are evidence-based tools designed to help patients and their families make difficult treatment decisions. LDKT decision aids can help ESRD patients, patients ’ family and friends, and healthcare providers engage in treatment decisions and thereby overcome multifactorial LDKT barriers.SummaryWe identified 12 LDKT decision aids designed to provide information about LDKT, and/or to help ESRD patients identify potential living donors, and/or to help healthcare providers make decisions about treatment for ESRD or living donation. Of these, four were shown to be effective in increasing LDKT, donor inquiries, LDKT knowledge, and willingness to discuss LDKT. Although each LDKT decision aid has limitations, adherence to decision aid development guidelines may improve decision aid utilization and access to LDKT.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Abstract Chronic kidney disease (CKD) is a frequent complication of HIV infection. The classic involvement of the kidney by HIV infection is HIV-associated nephropathy (HIVAN), occurring typically in young adults of African ancestry with advanced HIV disease in association with APOL1 high-risk variants. HIV-immune complex disease is histologically the second most common diagnosis. With the introduction of antiretroviral therapy (ART), there has been a decline in the incidence of HIVAN, with an increasing prevalence of focal segmental glomerulosclerosis. Several studies have demonstrated overall improvement in kidn...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
by Craig Klugman, Ph.D. Few people would say that the system of payment and organ distribution is perfect. About 37 million Americans suffer from kidney disease and 94,831 are candidates (as of July 10, 2019) for kidney transplant. In 2018, 21,167 kidney transplants and 836 combined kidney/pancreas transplants were performed in the U.S. Many ESRD patients (468,000) receive dialysis treatment, usually in privately owned clinics, while 193,000 have received a transplant. The system of distribution of kidneys was changed a year ago, when the system sought to increase the number of successful transplants by decreasing the amou...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Clinical Trials & Studies Featured Posts Health Care Health Regulation & Law HIV/AIDS Informed Consent Organ Transplant & Donation Privacy Public Health Source Type: blogs
African Americans have persistently poor access to living donor kidney transplants (LDKT). We conducted a small randomized trial to provide preliminary evidence of the effect of informational decision support ...
Source: BMC Nephrology - Category: Urology & Nephrology Authors: Tags: Research article Source Type: research
uml;z H Abstract End-stage renal disease in the human immunodeficiency virus-positive population is increasing. Kidney transplant is the optimal therapy for this population rather than dialysis modalities if some criteria are met. These include undetectable plasma human immunodeficiency virus RNA, CD4 cell count over 200 cells/μL, and the absence of any AIDS-defining illness. Here, we describe the first living-donor kidney transplant in a human immunodeficiency virus-positive recipient in Turkey. The patient, a 52-year-old male diagnosed as human immunodeficiency virus positive, was on antiretroviral therapy, w...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
Kidney transplantation remains the preferred treatment for the>678,000 adults with end stage renal disease (ESRD) compared to dialysis. ESRD incidence continues to increase while the gap between the number of kidneys needed and the number of organs available continues to widen. Predictive models that may be incorporated in shared decision aids could be helpful to communicate treatment benefits and risks to patients. We aimed to compare predictive modeling strategies for 5- and 10-year graft and patient survival comparing deceased donor kidney transplantation (DDKT) and living donor kidney transplantation (LDKT).
Source: Annals of Epidemiology - Category: Epidemiology Authors: Tags: Methods Source Type: research
Conclusions PCPs identified important barriers and facilitators to conservative care for their older patients with Stage 5 CKD. Further investigation of potential strategies that address barriers and enable facilitators is required to improve the quality of conservative care for older adults in the community.
Source: Nephrology Dialysis Transplantation - Category: Urology & Nephrology Authors: Tags: Chronic Kidney Disease Source Type: research
Aetna’s August 15 announcement that is reducing its marketplace participation from 778 to 242 counties has further focused attention on the need to stabilize marketplace risk pools. The Centers for Medicare and Medicaid Services (CMS) have already taken a number of steps toward this end this year, such as tightening up special enrollment periods, improving data matching procedures, and proposing regulatory changes to discourage the sale of short-term or fixed indemnity policies, which siphon off healthy individuals from ACA-compliant comprehensive coverage. On August 18, CMS took a further step, addressing a concern ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage Medicaid and CHIP Medicare APTC risk pools Source Type: blogs
Authors: De'Marziani G, Soler Pujol G, Obregón LM, Morales EM, Gonzalez CD, Gonzalez Paganti L, Cacciagiú L, Lopez G, Schreier L, Elbert A Abstract In Argentina, there have been no studies aimed at establishing the prevalence of dysglycaemia (impaired fasting glucose [IFG], impaired glucose tolerance [IGT] and diabetes mellitus [DM]) in patients with chronic kidney disease (CKD). Our group decided to conduct an observational study to evaluate the frequency with oral glucose tolerance test (OGTT) in CKD patients with no previous data for dysglycaemia in their medical records. OGTT was performed in 254 ...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Conclusions Self-efficacy and social accountability are motivators for self-management, although adherence can be mentally and physically taxing. Multicomponent interventions incorporating personalized care planning, education, psychosocial support, decision aids, and self-monitoring tools may foster self-management capacity and improve transplantation outcomes.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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Source: Electrophoresis - Category: Biochemistry Authors: Tags: Research Article Source Type: research
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