Hamid Marzan, Gill Jasleen, Okoh Princess, Yanga Nawang, Gupta Vardaan, Zhang Jing Chen, Singh Navneet, Matelski John, Boakye Priscilla, James Carl E, Waterman Amy, Mucsi Istvan
Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Stanford University School of Medicine, Stanford, California, USA.
Kidney Int Rep. 2023 Sep 22;8(12):2569-2579. doi: 10.1016/j.ekir.2023.09.018. eCollection 2023 Dec.
Variable transplant-related knowledge may contribute to inequitable access to living donor kidney transplant (LDKT). We compared transplant-related knowledge between African, Caribbean, and Black (ACB) versus White Canadian patients with kidney failure using the Knowledge Assessment of Renal Transplantation (KART) questionnaire.
This was a cross-sectional cohort study. Data were collected from a cross-sectional convenience sample of adults with kidney failure in Toronto. Participants also answered an exploratory question about their distrust in the kidney allocation system. Clinical characteristics were abstracted from medical records. The potential contribution of distrust to differences in transplant knowledge was assessed in mediation analysis.
Among 577 participants (mean [SD] age 57 [14] years, 63% male), 25% were ACB, and 43% were White Canadians. 45% of ACB versus 26% of White participants scored in the lowest tertile of the KART score. The relative risk ratio to be in the lowest tertile for ACB compared to White participants was 2.22 (95% confidence interval [CI]: 1.11, 4.43) after multivariable adjustment. About half of the difference in the knowledge score between ACB versus White patients was mediated by distrust in the kidney allocation system.
Participants with kidney failure from ACB communities have less transplant-related knowledge compared to White participants. Distrust is potentially contributing to this difference.
与移植相关的知识差异可能导致活体供肾移植（LDKT）的获取存在不公平现象。我们使用肾移植知识评估（KART）问卷，比较了非洲、加勒比和黑人（ACB）患者与加拿大白人肾衰竭患者之间的移植相关知识。
这是一项横断面队列研究。数据收集自多伦多成年肾衰竭患者的横断面便利样本。参与者还回答了一个关于他们对肾脏分配系统不信任的探索性问题。临床特征从医疗记录中提取。在中介分析中评估了不信任对移植知识差异的潜在影响。
在577名参与者中（平均[标准差]年龄57[14]岁，63%为男性），25%为ACB患者，43%为加拿大白人。45%的ACB患者与26%的白人参与者KART得分处于最低三分位数。多变量调整后，ACB患者处于最低三分位数的相对风险比相对于白人参与者为2.22（95%置信区间[CI]：1.11，4.43）。ACB患者与白人患者之间知识得分差异的约一半是由对肾脏分配系统的不信任介导的。
与白人参与者相比，ACB社区的肾衰竭参与者移植相关知识较少。不信任可能是造成这种差异的原因。
