The objective of this study was to investigate dialysis staff ( n  = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States.

Kidney transplantation (KT) can improve the quality of life for end-stage renal disease (ESRD) patients, however, not all ESRD patients have equal access to transplant.

Past studies have indicated gaps in all stages of the transplant process, where racial/ethnic minorities (vs. whites) and females (vs. males) are less likely to access several of the required steps necessary to receive a kidney transplant.

Racial / ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease ( ESRD ) patients have been well documented, but few studies have explored health care staff attitudes toward these inequalities .

Staff perceptions can influence patient care and outcomes, and identify staff perceptions on disparities could aid in the development of potential interventions to address these health inequities.


This is a mixed methods study that uses both deductive and inductive qualitative analysis of a dialysis staff survey conducted in 2012 using three open-ended questions that asked staff to discuss their perceptions of factors that may contribute to transplant disparities among African American, female, and cancer patients

Study results suggested that the majority of staff ( n  = 255, 28%) are patients' low socioeconomic status as the primary theme related to why renal transplant disparities exist between African Americans and non-Hispanic whites.

Staff cited patient perception of old age as a primary contributor ( n  = 188, 23%) to the disparity between young and elderly patients. The dialysis staff responses on gender transplant disparities suggested that staff were unaware of differences due to limited experience and observation ( n =  76, 14.7%) of gender disparities.

The study explored Southeastern US dialysis facility staff perspectives on the primary contributors to disparities in kidney transplant access. Additionally, the study highlights a few issues that are central to efforts in improving access for vulnerable groups, specifically AA, older, or female ESRD patients. 

These findings suggest that dialysis facilities should educate staff on existing renal transplantation disparities, particularly gender disparities, and collaboratively work with transplant facilities to develop strategies to actively address modifiable patient barriers for transplant .