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Decision-making about suitability for kidney transplantation: Results of a national survey of Australian nephrologists

Cass, Alan, Cunningham, Joan, Anderson, Kate, Snelling, Paul L., Colman, Sam, Devitt, Jeannie, Preece, Cilla and Eris, Josette (2007). Decision-making about suitability for kidney transplantation: Results of a national survey of Australian nephrologists. Nephrology,12(3):299-304.

Document type: Journal Article
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IRMA ID 10010xPUB30
Title Decision-making about suitability for kidney transplantation: Results of a national survey of Australian nephrologists
Author Cass, Alan
Cunningham, Joan
Anderson, Kate
Snelling, Paul L.
Colman, Sam
Devitt, Jeannie
Preece, Cilla
Eris, Josette
Journal Name Nephrology
Publication Date 2007
Volume Number 12
Issue Number 3
ISSN 1320-5358   (check CDU catalogue  open catalogue search in new window)
Start Page 299
End Page 304
Total Pages 6
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
Field of Research 1103 - Clinical Sciences
HERDC Category C1 - Journal Article (DEST)
Abstract Aim: This study aimed to elucidate the factors affecting nephrologists' decision-making on patients' suitability for kidney transplantation. Given the reduced access to transplantation for Indigenous Australians, the role of patient's ethnicity was of particular interest.

Methods: A postal survey of practising nephrologists and trainees was undertaken in Australia. Each participant was provided with a unique set of 15 hypothetical patient descriptions, with demographic, clinical and behavioural factors randomly generated to ensure an overall balance of factors across the cases. The main outcome measure was whether kidney transplantation was recommended.

Results:
Responding nephrologists and trainees were more likely to recommend transplantation for hypothetical patients who were young, of normal weight and described as compliant. They were less likely to recommend transplantation for smokers, or for people with diabetes or heart disease. No significant differences related to the patients' sex or ethnicity. The geographical location of the respondent was a significant determinant, with differences according to their State/Territory and their metropolitan/non-metropolitan location.

Conclusion: When all other factors were held constant, nephrologists and trainees appear to base their decision-making regarding suitability for transplant on clinical and behavioural factors, rather than on the basis of ethnicity or sex. In practice, however, clinical and behavioural factors cluster with ethnicity, and this is likely to contribute to the current poor access to transplantation for Indigenous end-stage kidney disease patients. Apparent differences in decision-making according to the respondent's location may reflect variations in practice across the country.
Keywords access
indigenous Australian
kidney transplantation
survey
DOI http://dx.doi.org/10.1111/j.1440-1797.2007.00784.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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