Perception Regarding Live Kidney Donation in the General Population of South Korea

This study aimed to know how the general population recognizes live kidney donation in Korea. Participants were randomly selected from the general population after proportional allocation by region, sex, and age. Selected participants received a questionnaire that included demographic information, socioeconomic and marital statuses, prior recognition of live donor KT, expected changes after donation, and the need for support after donor nephrectomy. Among the 1,000 participants from the web-based survey, 83.8% answered they fully understood living donor KT, 81.1% knew about them, and 51.1% were willing to donate. Various complications after nephrectomy and deterioration in health after donation were the most significant reasons for those reluctant to donate. Most agreed that the government should provide social and economic support to living kidney donors, especially after exposure to the description of donor nephrectomy. Financial support, including surgery and regular medical check-up costs, was the most preferred government support. The Korean general population seemed aware of the value and safety of kidney donation, although only half of them were willing to donate due to concerns about possible complications. Most participants agreed on social and economic support for living kidney donors, especially surgery-related costs.

Perception Regarding Live Kidney Donation in the General Population of South Korea

Background: It is necessary to know how the general population recognizes live kidney donation in Korea, where living donor kidney transplantations (KT) are the mainstream.Methods: Participants were randomly selected from the general population after proportional allocation by region, sex, and age. Selected participants received a questionnaire that included demographic information, socioeconomic and marital statuses, prior recognition of live donor KT, expected changes after donation, and the need for support after donor nephrectomy.Results: In total, 1,000 participants responded to the web-based survey. After reading the detailed explanation, 83.8% of the respondents answered that they fully understood living donor KT. Among the participants, 811(81.1%) answered that they knew about living donor KT, and 51.1% were willing to donate. Various complications after nephrectomy (54.4%) and deterioration in health after donation (69.1%) were the most important reasons for those who were reluctant to donate, and the possibility of a decrease in economic activities after donation accounted for 33.8%. Overall, 73.2% were more likely to agree that the government should provide social and economic support to living kidney donors; this number increased to 81.3% after exposure to the description of donor nephrectomy (P<0.001). Financial support, including surgery (74.2%) and regular medical check-up costs (70.1%), was the most preferred government support.Conclusions: The Korean general population seemed to be aware of the value and safety of kidney donation, although only half of them were willing to donate due to concerns about possible complications. Most participants agreed on social and economic support for living kidney donors, especially for surgery-related costs.

Critical timing of ACEi initiation prevents compensatory glomerular hypertrophy in the remaining single kidney

Increasing evidence suggests that single in kidney states (e.g., kidney transplantation and living donation) progressive glomerulosclerosis limits kidney lifespan. Modeling shows that post-nephrectomy compensatory glomerular volume (GV) increase drives podocyte depletion and hypertrophic stress resulting in proteinuria and glomerulosclerosis, implying that GV increase could serve as a therapeutic target to prevent progression. In this report we examine how Angiotensin Converting Enzyme inhibition (ACEi), started before uninephrectomy can reduce compensatory GV increase in wild-type Fischer344 rats. An unbiased computer-assisted method was used for morphometric analysis. Urine Insulin-like growth factor-1 (IGF-1), the major diver of body and kidney growth, was used as a readout. In long-term (40-week) studies of uni-nephrectomized versus sham-nephrectomized rats a 2.2-fold increase in GV was associated with reduced podocyte density, increased proteinuria and glomerulosclerosis. Compensatory GV increase was largely prevented by ACEi started a week before but not after uni-nephrectomy with no measurable impact on long-term eGFR. Similarly, in short-term (14-day) studies, ACEi started a week before uni-nephrectomy reduced both GV increase and urine IGF-1 excretion. Thus, timing of ACEi in relation to uni-nephrectomy had significant impact on post-nephrectomy “compensatory” glomerular growth and outcomes that could potentially be used to improve kidney transplantation and live kidney donation outcomes.

Evaluation of knowledge and attitudes towards kidney transplantation in patients undergoing hemodialysis at Muhimbili National Hospital, Tanzania.

Renal replacement therapy (RRT) is the treatment of choice for patients with End Stage Renal disease (ESRD), RRT include dialysis and kidney transplantation. Some sub-Saharan African countries including Tanzania have improved nephrology services dialysis and kidney transplant. This study aimed to assess knowledge, attitude and practices towards kidney transplantation among patients undergoing dialysis at Muhimbili National Hospital. This was a hospital based cross-sectional study that was conducted at Muhimbili National Hospital. A total of 190 patients were interviewed, majority were males 133(70%) with the age range of 18-80 years. Most patients 183(96.35%) were aware of Kidney transplantation the main source of information 175(95.6%) being hospital with 159 (86.9%) patients being aware of rules guiding kidney transplantation and 166 (90.7%) were aware of lifelong medication use after kidney transplantation. Knowledge on transplant was noted in 115(62.8%) with all of them being willing to receive kidney from blood related relatives. Majority 188 (64.5%) patients were not sure whether live kidney donation was better than deceased kidney donation. Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors and religious scholars. Large proportion considers Kidney Transplant positively but it limited by shortage of donors.