Patterns of primary care utilization before and after living kidney donation

Abstract

Background: Annual visits with a primary care provider (PCP) are recommended for living kidney donors to monitor long-term health postdonation, yet adherence to this recommendation is unknown.

Methods: We surveyed 1170 living donors from our center from 1970 to 2012 to ascertain frequency of PCP visits pre- and postdonation. Interviews occurred median (IQR) 6.6 (3.8-11.0) years post-transplant. We used multivariate logistic regression to examine associations between donor characteristics and PCP visit frequency.

Results: Overall, only 18.6% had less-than-annual PCP follow-up postdonation. The strongest predictor of postdonation PCP visit frequency was predonation PCP visit frequency. Donors who had less-than-annual PCP visits before donation were substantially more likely to report less-than-annual PCP visits postdonation (OR=_9.8 14.4_21.0, P<.001). Men were more likely to report less-than-annual PCP visits postdonation (adjusted OR=_1.2 1.6_2.3, P<.01); this association was amplified in unmarried/noncohabiting men (aOR=_2.4 3.9_6.3, P<.001). Donors without college education were also more likely to report less-than-annual PCP visits postdonation (aOR=_1.3 1.8_2.5 , P=.001).

Conclusions: The importance of annual PCP visits should be emphasized to all living donors, especially those with less education, men (particularly single men), and donors who did not see their PCP annually before donation.

Keywords: kidney transplantation; living donor; preventive healthcare; survey.