Background: Racial and socioeconomic disparities are well known barriers to kidney transplantation (KT), especially among minority populations. Emerging evidence suggests social networks exist within hemodialysis clinics. The role of these social networks on KT is not yet fully understood.

Methods: A convenience sample from two urban hemodialysis clinics in Philadelphia resulted in a cohort of 116 English-speaking patients. The survey was conducted between July 2008 and December 2008 using the Dialysis Patient Transplant Questionnaire (DPTQ) to address barriers to KT. The survey was self administered by 29% of the cohort. Clinical and transplant data were extracted from the electronic medical record. Data was analyzed using independent t-tests, Fischer's exact test, and chi-square analysis.

Results: The mean age at enrollment was 58-years-old (22-87). Eighty seven percent self identified as non- Hispanic black, 9% as Hispanic, and 1% as White or other. Over a 5-year period, 12% of the cohort received a KT. The majority of the KT recipients (73%) were listed on the transplant list at the time of the interview (p=0.001). The rate of transplant was 11% among non-Hispanic blacks, and 40% among Hispanics (p=0.003). When asked about the likes and dislikes of hemodialysis, patients who received a KT liked the social aspect of hemodialysis (p=0.049) and did not like the physical benefits of hemodialysis treatment (p=0.031). There were no differences in the external social networks of patients who received a KT. There were also no racial/ethnic differences in liking the social aspects of hemodialysis.

Conclusion: In this cohort of urban patients with a low transplant rate, the hemodialysis clinic social network seems to provide a positive role toward transplantation. The dichotomy of transplant rates within the same hemodialysis clinic social network among Hispanics vs. non-Hispanic blacks requires further study in order to help develop effective interventions.

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