The relationship between social networks and pathways to kidney transplant parity: Evidence from black Americans in Chicago

Abstract

Research has shown that black dialysis patients in the United States are significantly less likely than their white peers to be evaluated and listed for a kidney transplant. Extrapolating from social network theory, I hypothesize that a lack of access to social contacts with information about kidney transplantation may hinder information transaction regarding the benefits of, and pathway to, transplantation. In 2007–2008, the following research questions were addressed in an investigation in Chicago, USA: (1) What is the role of social networks in providing information about kidney transplantation to black hemodialysis patients? (2) What is the relationship between social networks and a patient’s likelihood of being seen at a kidney transplant center? From a stratified sample of dialysis units in the area, a purposive sample of 228 black patients were surveyed while they received treatment about their social networks and kidney transplant status. It was found that the odds of black hemodialysis patients being seen at a kidney transplant center increase with income, and patients who have people in their social network with information about kidney transplant were significantly more likely to be seen at a kidney transplant center. Specifically, black dialysis patients who get informational social support from their dialysis team and social networks were significantly more likely to be seen at kidney transplant centers. I conclude that considering black dialysis patients’ social milieu can be complementary to the existing research regarding this public health crisis.

Hemodialysis Clinic Social Networks, Sex Differences, and Renal Transplantation

“…Weakly linked networks are characteristic of advice and expert networks, and the person in the center is the most influential. Whereas we found that patients in strongly interlinked networks completed more steps toward kidney transplantation, other studies found that patients in these networks were misinformed and failed to complete the steps (9). Whereas we found that patients in strongly interlinked networks completed more steps toward kidney transplantation, other studies found that patients in these networks were misinformed and failed to complete the steps (9).…”

“…First, in-center hemodialysis is the predominant treatment for end-stage renal disease (ESRD) in the United States (19). Little is known about the function and structure of hemodialysis patient social networks (6)(7)(8)(9); however, research examining the social support and information provided by clinic staff and other patients (21)(22)(23)(24)(25)(26) highlights the importance of social networks within the hemodialysis clinic. Little is known about the function and structure of hemodialysis patient social networks (6)(7)(8)(9); however, research examining the social support and information provided by clinic staff and other patients (21)(22)(23)(24)(25)(26) highlights the importance of social networks within the hemodialysis clinic.…”

Sex Differences and Attitudes toward Living Donor Kidney Transplantation among Urban Black Patients on Hemodialysis

“…To understand the barriers that may have prevented patients from getting a transplant had they been medically suitable, we deliberately included patients who may have been unsuitable for transplant. Moreover, their attitudes may have influenced others who were medically suitable (17)(18)(19). Severe PVD is a relative contra-indication to transplantation at our center and a known predictor of morbidity and mortality in ESRD (29), which may explain why these patients were less likely to want LDKT.…”

“…In our study, all patients were eligible to participate in the study, regardless of their candidacy for kidney transplantation. We reasoned that the concerns and attitudes of both potentially eligible and ineligible LDKT candidates might help us develop targeted interventions designed to increase LDKT rates among black women and alleviate some existing disparities (17)(18)(19).…”

Kidney transplant referral practices in southeastern dialysis units

“…Previous research suggests that a majority of dialysis patients [71.6% (11)- 94% (12)] are interested in getting a KTx. In our study, only 19% of the dialysis professionals completing this survey thought that >50% of their patients were interested in KTx.…”