Addressing Kidney Donation with Black Patients: A Guide for Physicians


Healthcare professionals, play a crucial role in addressing the disparities in kidney donation and transplantation among Black patients. A conversation between doctors and donors provided guidance on effectively communicating with Black patients about kidney donation, drawing insights from recent discussions with donors, recipients, and medical experts.

Understanding the Context

Joseph K. Melancon, MD, a transplant surgeon at George Washington University Hospital, highlights a significant issue: “In the minority communities, particularly African Americans, we tend to be very, very secretive about our medical problems. And that’s a problem.” This reluctance to discuss health issues can delay crucial interventions and limit potential donor opportunities.

Clive Callender, MD, FACS, a professor of surgery at Howard University College of Medicine, and a veteran in the field, adds, “When you’re over 45 and you’re a person of color, they don’t do urinalysis and tests for protein. And this is the earliest time that you can tell you have kidney failure.” This underscores the importance of proactive screening and early discussions about kidney health with Black patients.

Key Strategies for Effective Communication

Address the topic early and directly

Don’t wait for kidney disease to progress before discussing donation options. As Dr. Melancon suggests, “The best time to get a kidney transplant is actually before you’re on dialysis.” Introduce the topic of kidney health and potential donation needs during routine check-ups.

Provide comprehensive information

Tracy L. Chavous, a kidney recipient, shared her experience: “If I had known then what I know now, I would have been more on the side of trying to get a donor first.” Ensure patients have access to all relevant information about kidney disease, dialysis, and transplantation options.

Encourage open communication with family and friends

Dr. Melancon noted a study finding that “African American patients… did not even tell family members… that they have a problem.” Encourage patients to share their health status with their support network, as this can lead to potential donor opportunities.

Address fears and misconceptions

Cynthia Parker-Bolden, a kidney donor, shared, “I think in my age, you know, they’re thinking like the old Frankenstein movies and things like that.” Be prepared to dispel myths and provide accurate, up-to-date information about the donation process and outcomes.

Highlight the benefits of living donation

Dr. Melancon emphasizes, “When that person comes forward and they give you a kidney, they’re not just giving you a kidney… They are giving you life.” Clearly communicate the advantages of living donation over deceased donation or dialysis.

Discuss the positive impacts on donors

Peter D. Ford, a kidney donor, stated, “I’m more healthy now than I was 2 years 3 months ago.” Share stories and data about how donation can positively impact donors’ health and well-being.

Provide resources for self-advocacy

Chavous advised, “If you’re stalling, don’t waste any more time. Your life is important and time is of the essence.” Equip patients with tools and information to advocate for themselves in the healthcare system.

Address cultural and religious concerns

Parker-Bolden mentioned, “I’m a Christian. I have prayed about it, and I had total peace.” Be prepared to discuss donation in the context of patients’ cultural and religious beliefs.

Offer support in finding potential donors

Dr. Melancon suggested, “When you walk out that door for evaluation, you need to understand, I need to be talking to people about live donation.” Provide guidance on how to approach the topic with potential donors.

Emphasize the urgency and importance

Dr. Callender stated, “It’s a race against time once you are on dialysis.” Clearly communicate the time-sensitive nature of kidney disease and the benefits of early action.

Effectively communicating about kidney donation with Black patients requires sensitivity, cultural competence, and a comprehensive understanding of the unique challenges they face. By addressing this topic early, providing thorough information, and encouraging open communication, we can help increase living kidney donation rates and improve outcomes for Black patients with kidney disease.

As Dr. Callender concludes, “Kidney donation, especially living kidney donation, is something that is so beneficial to the donor as well as to the recipient.” Our role as healthcare providers is to ensure this message reaches those who need it most, potentially saving and improving countless lives in the process.

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