Knowledge and Attitudes of Dialysis Patients Toward Kidney Transplantation: Preliminary Report from a Pilot Study Preceding a Cross-Sectional Nationwide Evaluation.

BACKGROUND: The knowledge and attitudes of dialyzed patients toward the best method of renal replacement treatment (ie, kidney transplantation [KTx]) may be the main factor motivating them to apply and be put on the national kidney transplant waiting list, resulting in a better prognosis. OBJECTIVE: Assessment of the knowledge and attitudes of dialyzed patients toward KTx. METHODS: A pilot study is considered an introductory step before the nationwide project, which will cover dialysis centers in Poland from 2023 to 2024. The authorship 4-part questionnaire, including self-assessment knowledge, attitude dimension, pain and mental evaluation section, was made available to 30 patients with hemodialysis aged 30 to 75 years. RESULTS: The median age of the patients was 59 years. The primary cause of end-stage renal disease (ESRD) was glomerulonephritis (33%). Most of the patients stayed on hemodialysis for 2 years or less (57%); 43% of the patients declared insufficient knowledge in the field of KTx, 41% of the patients were not informed at the nephrology clinic that KTx remains one of the methods of renal replacement therapy, and 65% did not receive information about the possibility of preemptive or early transplantation from a relative donor. Only 34% of the patients considered KTx to be a much better treatment option than dialysis, but only 20% of those were on the national waiting list for KTx. CONCLUSIONS: The pilot study showed insufficient knowledge of patients with ESRD regarding kidney transplantation as a method of renal replacement therapy. There is a need to introduce an effective educational program.

Blood donation practice and its associated factors among Polish population: secondary data analysis.

Introduction: Blood transfusion is an intervention widely used in therapeutics (e.g., in the perioperative period), thus, knowledge about factors associated with blood donation is important. The aim of this study was to investigate the impact of sociodemographic factors, personal values and life satisfaction on blood donation in Poland. Methods: Secondary analysis of data. A multiple logistic regression was carried out to assess the relationship between sociodemographic factors, life satisfaction (Satisfaction with Life Scale), personal values (Personal Values List) and blood donation. Results: Of the 770 respondents aged 18-65 years, 262 respondents (34%) donated blood at least once in their lives. Respondents who believed that blood donation is safe (OR = 1.71; Cl95%: 1.20 to 2.43), were male (OR = 1.47; Cl95%: 1.26 to 1.72), married (OR = 1.31; Cl95%: 1.11 to 1.54) and those with high school education (OR = 0.81; Cl95%: 0.66 to 0.99) were more often blood donors. Conclusion: Perceived blood donation safety and sociodemographic factors such as gender, marital status, and education level may influence blood donation. Health education is necessary to increase knowledge and shape positive attitudes toward blood donation among the society.

Nutritional Risk Assessment and Adverse Events in Patients Undergoing Left Ventricular Assist Device Implantation-A Retrospective Cohort Study Using Hospital Information System.

Clinical or subclinical malnutrition occurs in 30% to 70% of patients with advanced heart failure and increases the risk of postoperative adverse events. The main objective of this study was to assess the nutritional status of patients prior to left ventricular assist device (LVAD) implantation using different methods of malnutrition assessment and to evaluate the relationship between nutritional status and postoperative adverse events. A retrospective cohort study included 120 patients aged 26-74 years referred for LVAD surgery. Preoperative nutritional status (NRS-2002-Nutritional Risk Score 2002, NRI-Nutritional Risk Index, PNI-Prognostic Nutritional Index; TLC-total lymphocyte count) and postoperative adverse events were assessed. Moderate to severe malnutrition was found in 55.8%, 43.3%, 40.0%, and 20% of all patients, respectively, according to the PNI, NRI, TLC, and NRS-2002 scores. Patients with a TLC < 1200 cells/m3 had a higher risk of postoperative acute renal failure [hazard ratio (HR): 2.5; 95% confidence interval (95% CI): 1.01-6.3] and death during the observation period [HR = 2.1; 95% CI: 1.2-3.5]. Moderate to severe malnutrition was also associated with a significantly increased risk of in-hospital death [for the NRI score, HR = 4.9 (95% CI: 1.1-22.0); for the PNI score, HR = 5.0 (95% CI: 1.1-22.3)]. In conclusion, moderate to severe malnutrition prior to LVAD implantation has been identified as a risk factor for postoperative acute renal failure and mortality. Assessment of nutritional risk may improve patient selection and early initiation of nutritional support.

Polish attitudes towards unspecified kidney donation: a cross-sectional study.

BACKGROUND: Chronic kidney disease effects about 4.2 million people in Poland, yet Polish organ donation research is rare. In addition, compared to other countries in the world, Poland has a relatively low living donation rate. Still, little is known about how Poles would react to the possibility of living kidney donation to strangers. A study was conducted to examine public opinion about living kidney donation, as well as their knowledge about it, willingness to donate to a stranger, and support for a possible expansion of existing Polish organ donation legislation to include living donation to strangers. METHODS: A self-report questionnaire, which included a socio-demographic datasheet (9 questions), 16 questions about attitudes towards living donation, and 1 question about knowledge concerning transplantation law was sent to the respondents from December 2020 - February 2021. Logistic regression was used to assess factors affecting the support of the legalization of unspecified kidney donation amongst the participants. RESULTS: More than sixty percent (62.1) of respondents supported legalization of unspecified living kidney donation. Such legalization would be accepted by people who accept a choice of a family member to donate a kidney to a stranger (OR = 3.50; Cl 95%: 1.49 to 4.85), who think bone-marrow transplant is safe (OR = 2.65; Cl 95%: 1.80 to 3.91), recognize the benefit of carrying out tests before donating a kidney (OR = 2.56; Cl 95%: 1.79 to 3.69), would agree to receive a kidney from another person (OR = 2.24; Cl 95%: 2.53 to 3.13), or would agree to donate organs after death (OR = 2.06; Cl 95%: 1.45 to 2.95). However, support for unspecified living kidney donation would not be given by respondents fearing the risk of organ trafficking (OR = 0.54; Cl 95%: 0.38 to 0.79). CONCLUSIONS: In Poland there is strong support for legalization of unspecified living kidney donation. It is vital that future legislation define organ trafficking as a crime with serious punishment so that legal unspecified living kidney donation is not hindered. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (ID: NCT04789122 ) on 08/03/2021.

Factors Associated with the Willingness to Become a Living Kidney Donor: A National Cross-Sectional Study.

INTRODUCTION: Living donor kidney transplantation is the preferred method of treating kidney failure. The donor agrees to undergo an elective procedure for the benefit of the recipient. AIM: To assess the attitude toward living kidney donation and to investigate the factors that contribute to kidney donation willingness. METHODS: A cross-sectional study was carried out between December 2020 and February 2021. The study covered a representative group of 953 Poles aged 18-77, living in all Polish voivodships. The relationship between sociodemographic factors, personal values (Personal Values List), the total score of life satisfaction (Satisfaction with Life Scale) and the willingness to donate a kidney to another human was assessed using a logistic regression model. RESULTS: The most frequently chosen personal values were: good health; physical and mental fitness; love and friendship; knowledge and wisdom. The most frequently chosen symbols of happiness were: good health, successful family life, being needed by others. The median satisfaction with life for the entire group was 20 [16; 24]. Voluntary donation of a kidney to another human being i.e., family, friends, strangers were more often declared by women (OR = 1.21; Cl95%: 1.03-1.42), for whom the most important symbol of happiness was a life full of adventures, travels (OR = 1.39; Cl95%: 1.06-1.82) and the most important personal value was goodness and tenderness (OR = 1.21; Cl95%: 1.05-1.40). Total scores of The Satisfaction with Life Scale correlated positively with the willingness to voluntarily donate a kidney (OR = 1.03; Cl95%: 1.003-1.06), while age correlated negatively (OR = 0.99; Cl95%: 0.98-0.99). CONCLUSIONS: Respondents who declare their willingness to be a living kidney donor are mainly female, for which the most important symbol of happiness is a life full of adventures and travel, and the most important values are personal goodness and tenderness. The desire to donate a kidney to another person decreases with age and grows with life satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04789122).

Exploring the motives of Israeli Jews who were living kidney donors to strangers.

Non-directed living donors are individuals who donate a kidney to a recipient with whom they have neither a genetic nor emotional relationship. Israel legalized this type of donation in 2008. After this law was implemented, living donations significantly expanded. The aim of this article was to determine the motivations, characteristics, and perioperative experiences of non-directed living donors in Israel. Three online questionnaires (own questionnaire, Rosenberg Self-Esteem Scale (RSES), Rushton Self-Report Altruism Scale) were distributed to 180 Jewish kidney donors with the help of Matnat Chaim organization. One hundred and fifteen responses were received (69.3% response rate). The motivation for most donors (60%) was a strong willingness to help and a desire to do good. The majority of donors (78.3%) reported their health status as unchanged after donation; however, 16.5% experienced clinical problems (eg, wound infection, more pain than expected), and 5.2% experienced psychological complications. About 18% reported their health to improve after donation. Most (80%) inspired someone else to also become a kidney donor. This study breaks the myth that Jews do not support organ donation. In fact, their high level of altruism and their positive experience with donation has propelled the practice of non-directed donation in Israel.