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Socioeconomic Differences in Hypertension Management and Self-Care in Living Kidney Donors

Undergraduate #367
Discipline: Social, Behavioral, and Economic Sciences
Subcategory: Social Sciences/Psychology/Economics

Aswad Jackson - Tougaloo College
Co-Author(s): Tanjala S. Purnell, Lisa Cooper, Allan Massie, and Dorry L. Segev, John Hopkins School of Medicine/Public Health, Baltimore, MD Xun Luo and Saad Anjum, Johns Hopkins School of Medicine, Baltimore, MD



Live donor kidney transplantation provides improved life expectancy and quality of life for clinically-suitable patients with end stage renal disease. However, some live kidney donors are at increased risk of developing hypertension. For donors who develop hypertension, little is known about the association of employment status with self-care behaviors (e.g., healthy diet, physical exercise, and medication adherence). We conducted a retrospective phone survey among 90 adults who underwent live kidney donation at Johns Hopkins Hospital between 1979 and April 2014 and later developed hypertension. We hypothesized that higher socioeconomic status donors would adhere to better self-care behaviors than lower socioeconomic status. Using chi-square analysis, we found that donors who are employed full-time were more likely to be on a diet to control their blood pressure than donors who were not employed full-time (40% vs. 34%, p= 0.03). However, donors who were employed full-time were also more likely to report that there were days when they did not take their blood pressure medicine (24% vs 7%, p= 0.02), and more likely to report that they felt stressed because of daily hassles or personal problems in their lives (67% vs 41%, p= 0.01). The results show that donor employment status may be associated with their abilities to adhere to self-care behaviors. This understanding may allow for programs to target socioeconomic barriers to improve self-care behaviors in donors who develop hypertension. Future research will include continued collection of data from donors to furthermore study socioeconomic differences in hypertension management and self-care in living kidney donors.

Funder Acknowledgement(s): This work was supported by the NIDDK(Grant R01DK096008) as part of the WHOLE DONOR cohort study (PI: Dorry Segev). Aswad Jackson was supported by a grant from the NHLBI as a Jackson Heart Study Scholar at Tougaloo College.

Faculty Advisor: Tanjala Purnell, tpurnel1@jhmi.edu

Role: The research I did included completion of telephone surveys from hypertensive donors, medical record abstractions from hypertensive donors, and statistical analysis of hypertension data. During the telephone surveys, I asked donors questions regarding the quality of hypertension care that they have received from their primary care doctors. I also helped in medical record abstractions, in which we obtained medical records from the donor’s primary care physician. These abstractions were used to obtain some of the values of tests that were completed when donors saw their primary care physician. Finally, I used STATA for the statistical analysis of data from the hypertensive donors to examine the socioeconomic differences in the hypertension management and self-care.

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This material is based upon work supported by the National Science Foundation (NSF) under Grant No. DUE-1930047. Any opinions, findings, interpretations, conclusions or recommendations expressed in this material are those of its authors and do not represent the views of the AAAS Board of Directors, the Council of AAAS, AAAS’ membership or the National Science Foundation.

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