Nephrologists' perceptions of renal transplant as treatment of choice for end-stage renal disease, preemptive transplant, and transplanting older patients: An international survey

Objectives: To explore the relation between nephrologists' characteristics and their views of transplant as the treatment of choice for end-stage renal disease, preemptive transplant, and transplant of older patients. Materials and Methods: A comprehensive international Web-based survey explored the relation between nephrologists' characteristics and their views of transplant as the treatment of choice for end-stage renal disease, preemptive transplant, and transplant of older patients. Results: A total of 1448 nephrologists completed the survey. The majority of respondents agreed with transplant as the treatment of choice for end-stage renal disease (75%), preemptive transplant (71%), and transplant for patients > 60 years of age (59%). The likelihood of agreement was higher among transplant and academic nephrologists, and practice at hospitals with ≥ 50 transplants per year. Urban location and ≤ 10 years in practice were associated with higher likelihood of viewing transplant as treatment of choice and favoring preemptive transplant. Conclusions: Demographic and practice characteristics influence nephrologists' attitudes about transplant as the treatment of choice for end-stage renal disease, preemptive transplant, and transplant as an option for older patients. Detailed studies exploring the determinants of nephrologists' attitudes are likely to identify sources of variations in perceptions of patient suitability for transplant. Our findings underscore the need for continuing educational programs addressing evolving aspects of transplant particularly targeting nephrologists practicing within nonacademic centers and in rural areas.