Taking Specific Steps to Pursue Living Donor Kidney Transplant is Associated with Greater Odds of Receiving a Living Donor Offer
Notice bibliographique
Résumé
Background Living Donor Kidney Transplant (LDKT) is the optimal treatment for patients with End-Stage Kidney Disease (ESKD), however many eligible candidates are not able to receive LDKT. To our knowledge, no published studies have assessed the relationship between taking steps to pursue LDKT and the likelihood of securing an offer of living donation (OLD). We explored the relationship between patients taking specific actions to pursue LDKT and having received an OLD. Methods We used a cross-sectional, convenience sample of adult patients with ESKD from several hospitals in the Greater Toronto Area. Non-English speaking patients and patients unwilling to consent were excluded. Patients were asked whether they had taken specific steps in pursuing LDKT (exposure variables, see Table 1) and if anyone had offered to be a living donor for them (outcome variable). Univariable and multivariable logistic regression was used to analyze the association between exposure and outcome variables in STATA14. Results Data from 367 participants was analyzed. The mean (±SD) age was 58(±13) years, and 60% (221) of participants were male. Seventy one percent (260) of patients reported having greater than 12 years of education and 46% (168) were married or in a common-law relationship. The median time patients had been on dialysis was 2.1 years (IQR: 1.0-5.2 years) and 43% (156) had diabetes. Thirty eight percent (141) were White while 32% (117) were Black. Forty five percent (164) reported having received an OLD. Patients who reported having asked potential donors directly to be tested for eligibility were more likely to have received an OLD (OR=9.31, CI: 4.21-20.60, P<0.05) compared to those who had not yet asked. The association remained significant after adjusting for age, gender, education, ethnicity, marital status and transplant knowledge score (OR=6.80, CI: 2.89-16.00, P<0.05). Similarly, patients who reported having spoken to family or friends about the possibility of getting LDKT were more likely to have received an OLD (OR=6.54, CI: 3.76-11.36, P<0.05), after adjusting for age, gender, education, ethnicity, marital status and transplant knowledge score. Similar results were seen for patients who had “allowed others to tell people of their willingness to pursue LDKT”, “talked to people about their interest in LDKT” and “shared educational material about LDKT”.Discussion Taking small, specific steps towards pursuing LDKT may lead to successfully securing a living donor offer. Thus, patients who appear to be unable or unwilling to take these steps may be at a significant disadvantage. Conclusion Patients who have actively taken steps to pursue living donation are more likely to have received an OLD compared to those who have not taken these steps. Future research will be needed to identify the potentially modifiable barriers to taking these steps and to develop interventions to help patients explore the optimal treatment for ESKD.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».