Background: In December 2014, the new kidney allocation system (KAS) was implemented and is expected to particularly benefit patients who have spent an extended time on dialysis. For patients to benefit, dialysis centers must be aware of the recent changes, but it is unclear what proportion of dialysis providers are aware and how this awareness may affect provider practices.

Methods: With support of 18 ESRD Networks, all U.S. dialysis facilities with waitlist rates in the lowest national third (<15.2%) were asked to participate in a randomized effectiveness-implementation study called Allocation System Changes for Equity in kidNey Transplant (ASCENT). Medical directors of 1,529 facilities were sent surveys with questions about referral practices and KAS knowledge, including “Were you aware the national Kidney Allocation System changed in 2014?” Chi-square analyses were used to determine differences between providers aware vs. unaware of the KAS change.

Results: Of the 611 dialysis providers from unique facilities who completed surveys, 356 (58.3%) were aware KAS changed in 2014, and 255 (41.7%) were unaware. Most medical directors (84.8%) were aware of the change compared to 47.6% of nurse managers or facility administrators, 72.0% of social workers, and 42.3% of other staff. Compared to those unaware, providers aware of the new KAS were more likely to report also being aware of the national black-white racial disparity in waitlisting (26.8% vs. 19.6%; p<0.001), referring more patients overall (17.7% vs. 11.6%; p=<0.001), and referring more patients with 4+ years on dialysis (12.9% vs. 3.4%; p=<0.001) since implementation of the new KAS. Discussion: Almost half of dialysis providers were unaware of KAS changes; initiatives are needed to improve awareness. Survey results indicate that an awareness of the new policy may be associated with referring more patients, especially those who may benefit from the new KAS (e.g. patients with longer time on dialysis).

CITATION INFORMATION: Basu M, Smith K, Pastan S, Plantinga L, Mohan S, Escoffery C, Chung J, Melanson T, Patzer R. Awareness of Change in the Kidney Allocation System Among Dialysis Providers from Facilities with Low Waitlisting. Am J Transplant. 2017;17 (suppl 3).

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