Knowledge, Attitude and Perception (KAP) about Renal Transplantation of CKD Patients and their Care Givers

Abstract

Background Renal transplantation is still not increasing in developing countries as expected despite of its relative economic benefit and large donor pool from inter connected family structure. In this study the status of knowledge about kidney disease and option of transplantation was assessed in pre ESRD patients and their care givers. Method A KAP-33 questionnaire comprising 33 items was developed from published surveys and this was administered by an interviewer. It had 4 classes as knowledge on kidney disease (9 items), transplantation (10 items), attitude (6 items) and perception (8 items). There were 3 possible answering options (yes/no/don’t know) indicating agree/disagree/no idea or optimum understanding/some understanding/no idea allocating a score of 4/2/0 respectively. Score is expressed as percentage of total or group maximum. Higher score indicated good KAP.Pre ESRD patients and their accompanying care givers attending in a tertiary renal care facility were included randomly in this pilot survey. Result In 100 subjects, 78 were patients and 22 care givers. Age was 48±13 vs. 54±17 yrs (P=NS) with similar sex distribution (M: F- 82:18 vs. 72:28, P=NS) respectively. Majority had primary level of education (64% vs. 50%, P=NS) and belonged to low to middle income (87% vs. 83%, P=NS). Predominant primary renal diseases in patients were diabetes (35%) and glomerulonephritis (30%) having serum creatinine 3.3±1.9 mg%. Average KAP score in all subjects for 25 scoring items (47±22) and separately in knowledge of kidney disease (54±30), transplantation (34±28), attitude (64±25) and perception (38±29) classes was generally low with similarity for both patient vs. care givers (47±22 vs. 48±23, P=NS). Only 30% claimed to have adequate knowledge in transplantation while 43% none; information source was doctors 47% and relatives 33%; 79% agreed to involve in transplantation program; 65% had no knowledge about types of kidney donor; 99% preferred a related donor; only 16% agreed to preemptive transplantation and 72% believed about no religious restrictions to transplantation. Education level conferred significant higher KAP score (school vs. higher- 41±22 vs. 67±20, p<0.001) than income (low-middle vs. higher- 421±21 vs. 52±22, P=NS) or location (rural vs. urban- 48±25 vs. 49±20, P=NS). Conclusion Knowledge, attitude and perception towards renal transplantation is positively influenced by person’s educational level not the economic status. Until there is improvement in personal education level along with wide spread transplantation campaign, organ donation program will keep falling behind. Dr P Debnath, Nephrology, SSMC.