Early Transplant Education Increases CKD 3-5 Patients’ Knowledge and Informed Decision-Making About Chronic Kidney Disease and Living Donor Kidney Transplant
1UCLA David Geffen School of Medicine, Los Angeles, CA, 2Terasaki Institute, Los Angeles, CA, 3Research and Evaluation, Kaiser Permanente, Pasadena, CA, 4The Houston Methodist Research Institute, Houston, CA
Meeting: 2021 American Transplant Congress
Abstract number: 333
Keywords: Kidney transplantation, Patient education, Psychosocial
Topic: Clinical Science » Kidney » Kidney Psychosocial
Session Information
Session Name: Kidney Psychosocial
Session Type: Rapid Fire Oral Abstract
Date: Tuesday, June 8, 2021
Session Time: 4:30pm-5:30pm
Presentation Time: 5:05pm-5:10pm
Location: Virtual
*Purpose: Early education about chronic kidney disease (CKD) and living donor kidney transplant (LDKT) outside of transplant centers is inconsistent, with patients in CKD 3 and 4 and ethnic/racial minorities even less likely to receive it. Improvements in transplant educational delivery for early-stage CKD patients are needed.
*Methods: We conducted a prospective, parallel arm randomized controlled trial (RCT) with 971 patients varying by CKD Stage [3 (41.2%); 4 (34.4%), and 5 (24.4 spoken at Kaiser Permanente Southern California (KPSC). Patients were stratified by Stage, race/ethnicity, and primary language spoken and randomized to: (1) Explore Transplant@Home (ET), a supplementary video-guided, print and text-based education intervention delivered remotely or (2) standard of care KPSC transplant education (SOC). We fitted multilevel random effect models and compared changes in outcomes by condition 6 months post-baseline. Interactions between treatment condition and each stratifying variable were assessed.
*Results: CKD patients were diverse [White (22.2%), Black (18.4%), Asian (9.6%); English-speaking Hispanics (21.7 %), Spanish-speaking Hispanics: (28.0 %)]. Compared to SOC, patients receiving ET were twice more likely to make informed decisions about pursuing LDKT than those receiving SOC (1.99 [1.35, 2.92] p<.001). Increases in CKD symptom knowledge and transplant knowledge were also observed for the ET group at 6 months (p < 0.001) (Figures). There were heterogeneity of treatment effects for informed decision-making by CKD Stage (p = 0.067) and for DDKT self-efficacy by primary language spoken (p = 0.059).
*Conclusions: With this study showing promise in improving knowledge for earlier stage CKD patients and Spanish-speakers much earlier through ET, interventions to increase preemptive transplantation could utilize these educational methodologies to increase LDKT rates.
To cite this abstract in AMA style:
Waterman AD, Kawakita SH, Dub B, Iraheta YA, Murillo AL, Menser T, Mittman B. Early Transplant Education Increases CKD 3-5 Patients’ Knowledge and Informed Decision-Making About Chronic Kidney Disease and Living Donor Kidney Transplant [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/early-transplant-education-increases-ckd-3-5-patients-knowledge-and-informed-decision-making-about-chronic-kidney-disease-and-living-donor-kidney-transplant/. Accessed May 16, 2025.« Back to 2021 American Transplant Congress