Social networks and pathways to kidney transplantation

Research has shown that black dialysis patients are significantly less likely than their white peers to be evaluated and listed for a kidney transplant. Extrapolating from social network theory, I hypothesize that a lack of access to social contacts with useful information about kidney transplantation may hinder information transaction regarding the benefits of, and pathway to, renal transplantation. The following research questions were addressed in this empirical investigation of the social networks of black hemodialysis patients: (1) What is the role of social networks in providing information about kidney transplantation to black hemodialysis patients? (2) What is the relationship between social networks and a patient's likelihood of being seen at a kidney transplant center?;Ninety-four percent of patients surveyed were interested in a kidney transplant, and 98% had insurance coverage that would pay for a kidney transplant, but only 9% were active on a kidney transplant waiting list. Using logistic regression, black hemodialysis patients with lower incomes are less likely to be seen at a kidney transplant center (odds ratio = 1.38, p<.01), and patients who have people in their social network with information about kidney transplant are significantly more likely to be seen at a kidney transplant center. Specifically, black dialysis patients who get informational social support from their dialysis team (odds ratio = 1.76, p<.001) and social networks (odds ratio = 1.63, p<.001) are significantly more likely to be seen at kidney transplant centers.;In conjunction with other literature, the dissertation findings can be used to better understand racial disparity in kidney transplantation and provide insight for future research on this social problem. These findings suggest that special attention should be provided to the most disadvantaged patients as they navigate the kidney transplant pathway. Black patients with low incomes are in particular need of attention by kidney professionals, who can augment patients' social networks through their own interventions or by linking patients with mentors or patient navigators. Recommendations are particularly salient for Master's level social workers, as every dialysis unit mandates that they provide assistance to patients with psychosocial barriers to kidney disease treatment regimes.