Impact of a chronic kidney disease clinic on preemptive kidney transplantation and transplant wait times

Background-Despite the known benefits of preemptive kidney transplantation, its rate of use remains low. Objective-To determine whether focused, comprehensive education provided at a clinic for patients with chronic kidney disease would improve the rate of preemptive transplantation and transplant wait times. Methods-A retrospective cohort study design was used. The rate of preemptive transplantation and transplant wait times were compared between patients with end-stage renal disease who had been followed in a chronic kidney disease clinic for more than 3 months and patients with end-stage kidney disease who had not been followed for chronic kidney disease care during the same period. Results-More African Americans than others had initiated dialysis without having had previous care for chronic kidney disease. The rate of preemptive transplantation was 24% for patients followed in the clinic. For those patients without living donor options, mean transplant referral time was significantly different between patients followed at the clinic and patients who were not: 234 (SD, 392) days before dialysis was started versus 161 (SD, 525) days after dialysis was started (P=.01). Conclusion-A chronic kidney disease clinic can influence rates of preemptive kidney transplantation and transplantation referral times. (Progress in Transplantation. 2010;20:216-220)