Sept. 13, 2019
Chris Woodley • cwoodley@mailbox.sc.edu
Associate Dean for Faculty and Research Teri Browne, a leading researcher on kidney disease treatment and transplant access, recently served as co-author on an article that was published in the Journal of the American Medical Association. The article, Association Between Dialysis Facility Ownership and Access to Kidney Transplantation, published the results of a study that examined for-profit and non-profit dialysis facilities and their rates for living and deceased donor kidney transplantation.
The study used data from 2000 to 2016 from the United States Renal Data System, a national registry of every dialysis patient treated at 6,511 dialysis facilities in the United States. Of the nearly 1.5 million dialysis patients during the 16-year period, the majority were treated at for-profit facilities. But patients receiving dialysis at for-profit chains were nearly 60 percent less likely to be placed on the transplant wait list than those treated at non-profits. Meanwhile, patients at non-profits were half as likely to receive a living or deceased donor kidney transplant. The authors concluded that further research is necessary to understand the mechanisms behind the disparities.
According to the U.S. Department of Health and Human Services, 94,599 patients are awaiting kidney transplants in September 2019. This includes more than a thousand people (1,032) in South Carolina who are on the waiting list for a kidney transplant, which is the preferred treatment modality for kidney failure. Kidney disease is a unique practice area for social work, as the only Medicare-mandated requirement for a master’s level social worker is in dialysis and kidney transplant.
“Getting a kidney transplant is a complex process for people who are on dialysis, and many patients have difficulty navigating the steps on the pathway to transplant,” Browne says. “These steps include getting referred for a transplant and visiting a transplant center for different tests that will decide if patients are good candidates for transplant. Dialysis units play an important role in helping patients navigate these processes, and the Centers for Medicare and Medicaid Services require dialysis units to provide this help.”
Browne added that more research is needed to understand the full scope of kidney transplant disparities.
“We do not have national data on transplant referrals and how dialysis units are helping patients get kidney transplants,” Browne says. “We need more research on exactly what is happening in dialysis units before patients are put on a waiting list for a transplant or receive a transplant and see why these disparities in transplant rates are happening.”
Browne, who previously worked as a dialysis social worker, has co-authored several journal articles on kidney disease, including improving kidney transplant waitlists, reducing kidney transplant disparities and perceptions of long-term care residents’ candidacy for kidney transplantation. She is a former national chairperson of the Council of Nephrology Social Workers, a divisional board member of the End Stage Renal Disease Network of the South Atlantic and a board of directors’ member of the American Association of Kidney Patients.