Addressing Disparities in Living Donor Kidney Transplants: A Focus on African American Communities

Addressing Disparities in Living Donor Kidney Transplants: A Focus on African American Communities

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Developed in collaboration
Med-IQ      Duke Medicine

Online Course | Specialties: Internal Medicine, Nephrology, Primary Care
Released: 11/10/2021
Expires: 11/9/2022
Max Credits: 0.25
Continue to Course Read Abstract

Matthew J. Ellis, MD
Associate Professor of Medicine
Assistant Professor of Surgery
Kidney and Pancreas Transplant Program
Duke University School of Medicine
Durham, NC
Activity Planners
Amy Burdette, PhD
Manager, Educational Strategy and Content
Baltimore, MD

Kerry Kennedy, ELS
Editorial Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Jenny Cai
Montreal, QC
Learning Objective
Upon completion, participants should be able to:

  • Outline strategies to overcome barriers related to increasing living donor kidney transplants, particularly among African American communities

Target Audience
This activity is intended for nephrologists, primary care physicians, nurse practitioners, physician assistants, and nurses.
Statement of Need
The number of patients awaiting kidney transplantation—as well as the length of time spent waiting for a transplant—has increased during the past 2 decades. Living donor kidney transplantation (LDKT) provides a better chance for long-term, dialysis-free survival, with lower morbidity and mortality rates compared with dialysis and deceased donor transplantation. Only one-third of kidney transplants in the United States, however, are from living donors. In particular, African American patients are less likely than those from other racial/ethnic groups to receive a LDKT, despite the fact that the prevalence of end-stage renal disease is 2 to 4 times greater in African American individuals. Racial disparities in access to LDKT are seen at multiple steps along the kidney transplantation pathway, including referral, identification of potential living donors, evaluation, and treatment decision making. Factors contributing to these racial disparities for African American individuals include patient-centric factors, socioeconomic barriers, lack of knowledge about kidney transplantation, systemic healthcare factors, and mistrust of the healthcare system. Studies have found that educational strategies, culturally informed messaging, and live donor advocacy programs may successfully address several of these contributing factors. It is vital that nephrologists, primary care providers, and other healthcare providers increase their awareness and implementation of potential strategies to eliminate barriers to LDKT.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with Duke Health.

Med-IQ      Duke Medicine

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.
Medium/Method of Participation
This CE activity consists of a 0.25-credit online publication. To receive credit, read the introductory CE material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: November 10, 2021
Expiration Date: November 9, 2022

Estimated Time to Complete This Activity: 15 minutes

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Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 
Matthew J. Ellis, MD
Salary: CareDx
Consulting fees/advisory boards: RadMD LLC, Replimune Group Inc.

The writer, peer reviewers, and activity planners have no financial relationships to disclose.
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Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

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© 2021 Duke University Health System


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • Living donor kidney transplantations (LDKTs) account for only one-third of kidney transplant cases in the United States
  • Although the prevalence of kidney disease is higher among African American individuals compared with White individuals, African American patients are less likely to receive a kidney from a living donor
  • Factors contributing to racial disparities in transplantation for African American patients are complex and varied, consisting of patient-centric factors, socioeconomic barriers, structure of the healthcare system, mistrust of the healthcare system, and a lack of knowledge about kidney transplantation
  • Opportunities to reduce racial disparities in LDKT include improving patient education, enhancing practice-level cultural sensitivity, and implementing government policies

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