Must Health Literacy Be a Prerequisite for Kidney Transplantation?

[摘要] Patients with ESRD want kidney transplants! A study of the impact of health literacy on access of dialysis patients to transplantation in this issue of CJASN found 90% favoring transplantation as their preferred modality of therapy (1). Regardless of original kidney disease, age, gender, ethnicity, educational status, income level, dialysis provider, or health literacy, from a patient's perspective, transplantation is the best option. Yet fewer than 25% of patients with ESRD have functioning transplants, and only 20% of dialysis patients populate transplant waiting lists despite estimates that perhaps as many as half would live longer with a transplant than on dialysis (2-4). Why does delivery of renal replacement therapy (RRT) in the United States, offered to all Medicare-eligible patients as an entitlement accompanied by a mandate to provide optimal services, deviate so markedly from their expressed preferences (5)?

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome