Three posters highlighting AKF core programs presented at 2024 Spring Clinical Meetings

The American Kidney Fund (AKF) presented three posters at the National Kidney Foundation's Spring Clinical Meetings held on May 14-18, 2024, in Long Beach, California. The featured posters represented abstracts accepted by the National Kidney Foundation that highlight AKF initiatives. Here are summaries of the posters: 

Lower education levels associated with fewer patient-provider conversations about kidney transplant

Getting a kidney transplant is the best treatment option for people with kidney failure, however, many patients with end-stage kidney disease (ESKD) run into roadblocks when it comes to receiving a transplant. Having a conversation with health care professionals is one effective way for patients to learn about the transplant waitlist process; unfortunately, studies show that patient education levels can impact the quality and substance of information shared by providers in these conversations. 

To learn more about conversations taking place between patients and providers on treatment options for kidney failure, AKF randomly selected and surveyed 3,000 of its financial assistance recipients who have ESKD and are on dialysis or live with a kidney transplant. The survey, conducted in 2022, featured 30 questions on treatment modalities, provider conversations on treatment options, and barriers and drivers to treatments. 

The survey was completed by 856 respondents (a response rate of 29%) and showed that AKF financial assistance recipients have a high level of interest in transplant, with approximately 80% of those who took the survey indicating as such, but they face a lot of uncertainty around the waitlist process. While 93% of respondents said they've heard about transplant from health care professionals, patients without a high school degree reported fewer conversations about transplant with health care providers. More research is needed to understand how and why education level impacts the quality of patient-provider conversations and to identify ways to ensure that all patients, regardless of their education level, receive all the necessary information on transplant from health care professionals.

American Kidney Fund's financial assistance program alleviates financial barrier to kidney transplant among low-income individuals 

People who come from low socio-economic backgrounds are at an increased risk of their kidney disease progressing into kidney failure, but the high cost of health insurance premiums often prevents people from low socioeconomic backgrounds from qualifying for life-saving kidney transplants. AKF's Health Insurance Premium Program (HIPP) provides financial assistance to people with kidney failure who have health insurance but cannot afford to pay their premiums. 

AKF staff performed an analysis of self-reported data collected through HIPP applications from 2019 to 2022, and determined that the program made 6.6%, or 6,681 kidney transplants performed in the U.S. during that time possible. 

The proportions of these HIPP recipients who identified as Black or Hispanic (35.9% and 23.4%) – two populations that are more likely to experience lower levels of education and income and face greater barriers in accessing transplant than other populations – were notably higher than the proportions seen in the general population of people who receive kidney transplants (29.3% Black/African American and 19.4% Hispanic). More research is needed to determine if eliminating financial difficulties helps to ease the burden of other factors that impact access to kidney transplantation.

AKF's Kidney Health for All™ initiative — which works to change race and ethnicity from playing a significant role in kidney health outcomes — includes a recently published toolkit, Your Guide to Kidney Transplant, which provides information and resources to guide patients through the transplant process.

Patient perspective of hyperkalemia management: a focus group study 

People with chronic kidney disease (CKD) are at an increased risk for hyperkalemia (high potassium), a potentially life-threatening condition. When you have high potassium, your kidneys cannot remove the extra potassium in your blood, and over time, more and more potassium can build up, which can be dangerous. Proper management of potassium levels is crucial for individuals with CKD, however, there are inconsistencies that exist in clinical, and professionals vary in how they are practicing these guidelines. In addition, making updates to the guidelines to include the latest research is often slower than ideal. Due to these inconsistencies and changing professional guidelines, AKF conducted research to understand the perspective of individuals with CKD and identify where the knowledge gaps are on managing hyperkalemia.

In 2023, AKF conducted two virtual focus groups of individuals with CKD, one group with a history of hyperkalemia and the other with no history of hyperkalemia. Eight participants were recruited, and the participants varied in age, gender, race, educational background and stages of CKD. The findings of these focus groups revealed four distinct themes:

Those diagnosed with hyperkalemia showed a high understanding of the condition, while those without hyperkalemia had a moderate understanding, but struggled to state specifics; 

The most common questions about the condition are around the cause of hyperkalemia and proper food and nutrition recommendations; 

People with hyperkalemia mainly manage the condition through changes to what they eat and drink; and 

Patients preferred accessing educational materials online or through their health care providers in print or electronic format. 

AKF used these focus group findings to create a four-page patient-friendly hyperkalemia guide that explains the latest guidelines and addresses lifestyle management options. Future research should focus on the utilization of this patient-friendly material and its effect on patient outcomes.