Patients with a larger MVD on preoperative vein mapping are at lower risk for failure of fistula maturation and have increased long-term AVF patency. MVD is the only clinical or demographic factor associated with both AVF maturation and long-term patency. MVD is an important preoperative indicator of fistula success in assessment of potential AVF sites. Future predictive models of fistula maturation and patency should include MVD.

Background Health literacy (HL) may be a mediator for known socioeconomic and racial disparities in living kidney donation. Methods We evaluated the associations of patient and demographic characteristics with HL in living kidney donors (LD), living donor kidney transplant recipients (LDR), and deceased donor recipients (DDR) in a single center retrospective review of patients undergoing kidney donation or transplantation from September 2010 to July 2012. HL and demographic data were collected. HL was assessed via the Short Literacy Survey (SLS) comprising three self-reported screening questions scored using the 5-point Likert scale [low (3-8), moderate (9-14), high (15)]. Chi-square and logistic regression were used to test factors associated with lower HL. Results The sample included 360 adults (105 LD, 103 LDR, 152 DDR; 46±14 years; 70% white; 56% male; 14±3 years of education). HL scores were skewed (49% high, 41% moderate, 10% low). The distribution of HL categories differed significantly among groups (p=0.019). After controlling for age, race, gender, education and a race-education interaction term, DDR were more likely to have moderate or low HL than LDR (OR 1.911; 95%CI 1.096, 3.332; p=0.022) Conclusions Overall, living donors had high HL. The distribution of low, moderate and high HL differed significantly between LD, DDR and LDR. DDR had a higher likelihood of having low HL than LDR. Screening kidney transplant candidates and donors for lower HL may identify barriers to living donation. Future interventions addressing HL may be important to increase living donation and reduce disparities.

Most health literacy assessments are time consuming and are administered verbally. Written self-administration of measures may facilitate more widespread assessment of health literacy. The aim of this study was to determine the inter-method reliability and concurrent validity of the written administration of the three subjective health literacy questions of the Short Literacy Survey (SLS). The Rapid Estimate of Adult Literacy in Medicine (REALM) and the shortened Test of Functional Health Literacy in Adults (S-TOFHLA) were the reference measures of health literacy. 299 participants (52±13 years old, 56% female, 67% white) completed the written and verbal administrations of the SLS June-December 2012. Inter-method reliability was demonstrated when: a) the written (median=14, IQR: 12–15) and verbal SLS (median=14, IQR:11–15) did not differ (Wilcoxon signed rank test, p=0.085); and b) written and verbal scores were highly correlated (Spearman’s rho=0.788, p<0.001). The written items were internally consistent (Cronbach’s alpha=0.733). The written total score successfully identified persons with ≤ 6th grade equivalent for literacy on the REALM (AUROC = 0.753) and inadequate literacy on the S-TOFHLA (AUROC = 0. 869). The written administration of the SLS is reliable, valid, and is effective in identifying persons with limited health literacy.

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