Supported Research

Lay Abstract

Background: A kidney transplant is the best treatment for patients with kidney failure (KF). However, even though women have more KF than men, women are much less likely to receive a kidney transplant. The reason for this is unknown but may relate to differences in the attitudes of men and women towards transplant. For example, compared with men, women may be more unsure about wanting a transplant, less vocal about wanting one, more afraid of the procedure or concerned about potential medication side effects. However, such differences in attitudes towards kidney transplant in men and women and how these might impact receiving a transplant have not been previously studied. Methods: We will conduct a study in three phases. In the first phase, we will use focus group discussions (FGD) to speak with men and women who are either on dialysis or who have already been referred for a kidney transplant prior to dialysis start (pre-emptive referral) about their attitudes towards or concerns about receiving a kidney transplant. In the second phase, we will use the information we learned from the FGD to create a questionnaire to examine the major themes or concerns identified from the FGD. This questionnaire will be given to patients between 18 and 75 years of age either new to dialysis or pre-emptively referred for kidney transplant over a 20 month period, at 10 centers across Canada. The goal is to determine if there are significant differences in the attitudes of men and women with KF towards kidney transplant. Finally, in phase 3, we will determine if significant differences in attitudes between men and women are associated with differences in patients being referred for, and if referred, completing their transplant work-up in less than a year. We also aim to explore if differences in attitudes between men and women are associated with differences in access to having a living kidney donor. Conclusion: Equal access to kidney transplantation is extremely important, but can only happen when both men and women have an equal opportunity to be referred for and activated on the transplant waiting list. In this study, we will identify if significant differences in attitudes towards kidney transplant between men and women exist and if so, how these might impact access to transplant. Based on these results, we can focus our attention on the creation of patient and physician education programs, or patient engagement, as appropriate. This may lead to changes that will improve the proportion of women with KF who are referred for transplantation and strategies to aid in women completing their transplant work-up for potential activation on the transplant waitlist. It may also identify strategies to help both genders find potential living kidney donors. Ultimately the goal of this research is to ensure equal access to transplant for all Canadians, regardless of their gender.