Role of Educational Level in Kidney Transplant Outcomes

Abstract

Background: Kidney transplantation outcomes are correlated to many factors, including the socioeconomics conditions and the educational level. Methods: We evaluated the role of educational level on patient and graft survival in a population of 456 kidney transplant recipients. Patients were divided into two groups on the basis of their pre-transplant educational status: patients with primary education (elementary or middle school, as low education) were compared with patients with a secondary school education (high school or a university degree, as high education). Results: Among the 456 patients considered for this analysis, 161 patients had a low educational status, and 295 had a high educational status. Patients with a low educational status were more rarely employed (66.1% vs. 32.5%, p < 0.001), with a high rate of retired patients compared to high-educational status patients (35.6% vs. 10.6%, p < 0.001). Although the educational status did not influence the graft function, the 1-year (88.1% vs. 96.2%, p = 0.0008), 5-year (77.6% vs. 88.8%, p = 0.001), and 10-year (62.1% vs. 75%, p = 0.003) graft survival rates were significantly lower in patients with low educational status compared with high-educational status patients, respectively. Patient survival at 1-year (94.4% vs. 97.6%, p = 0.073), 5-year (85% vs. 92.5%, p = 0.011), and 10-year (75.7% vs. 83.4%, p = 0.042) follow-up was significantly lower in patients with low educational status. Conclusions: Low socioeconomic conditions and educational level had a negative impact on kidney transplant outcomes. Improving access to education and providing targeted educational support and health literacy could enhance treatment adherence and reduce disparities in transplant outcomes.

Keywords: deceased donor; educational status; employment; graft survival; income; kidney transplantation; living donor; patient survival; quality of life; socioeconomic conditions; work.

Figure 1

The Kaplan–Meier analysis demonstrated worse graft (A) and patient (B) survival in patients with low educational levels compared to patients with high educational levels.