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Kidney DisordersASCENTNCT02879812

Disparities in National Kidney Allocation Policy

A study testing Performance Feedback Reports, Educational Video for Staff and Educational Video for Patients in people with Kidney Disorders, run by Emory University at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the current study is to test a systems-level approach to disseminate a multicomponent, multilevel intervention consisting of educational materials about transplantation and the new kidney allocation system targeting dialysis facility medical directors, staff, and patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Kidney Disorders
What is being tested?
Performance Feedback Reports, Educational Video for Staff and Educational Video for Patients
Could I receive a placebo?
No, everyone receives an active treatment
How many people
56,332 participants
Where
3 sitesUnited States
Study dates
Sep 2016to 2 Aug 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Dialysis facilities with at least 25 patients composed of at least 10% African American and 10% Caucasian

Who cannot join

  • Dialysis facilities with wait listing rates above the national tertile

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Emory Clinic

    Atlanta, Georgia, 30322

  • Emory University Hospital

    Atlanta, Georgia, 30322

  • Emory University

    Atlanta, Georgia, 30322

Other trials in United States

About this study

Official title: Allocation System for Changes in Equity in kidNey Transplantation (ASCENT) Study

The purpose of the current study is to test a systems-level approach to disseminate a multicomponent, multilevel intervention consisting of educational materials about transplantation and the new kidney allocation system targeting dialysis facility medical directors, staff, and patients. Roughly 750 dialysis facilities in up to 18 End Stage Renal Disease Network regions across the United States will be randomized to receive intervention materials. The overall goal of the study is to extend the influence of the national allocation policy in reducing disparities in early steps in kidney transplant access.

Read the detailed description

The purpose of the Allocation System for Changes in Equity in kidNey Transplantation (ASCENT) study is to test a systems-level approach to disseminate a multi-component intervention consisting of in the era of the new national kidney allocation policy and educational materials targeting dialysis facility medical directors, staff, and patients. The investigators will randomize ~750 dialysis facilities in up to 18 End Stage Renal Disease Network regions across the United States, where approximately half of facilities will receive the intervention materials and half will receive an informational brochure. This pragmatic, clinical effectiveness-implementation study will test the effectiveness of the multicomponent, multilevel interventions consisting of a tailored, facility-specific transplant and disparity performance report, educational videos for staff and dialysis patients, and an educational webinar for dialysis facility medical directors and staff.

Being tested
Performance Feedback Reports, Educational Video for Staff, Educational Video for Patients, Educational Webinar, Standard Care
Keywords
Transplantation Surgery, Nephrology, Organ and Tissue Transplantation, End stage renal disease (ESRD)
Medical subject headings
Kidney Diseases, Kidney Failure, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Performance Feedback ReportsOther

    Also called Audit and Feedback Report

    Medical directors will be provided performance feedback reports that are a summary of clinical performance of transplant and racial disparity performance over a period of time aimed at providing information to allow them to assess and adjust their transplant performance. The report will emphasize tailored facility-specific information on the mean time on dialysis for patients in that facility and transplant access performance measures, such as wait listing and transplantation, including the magnitude of racial disparity, detailing when a facility is performing below the national or regional average.

  • Educational Video for StaffOther

    Dialysis facility staff will watch a ~10 minute educational video that describes the role of dialysis staff in improving transplant access, the new kidney allocation policy, and how the new policy impacts minority patients and those on dialysis for a substantial period of time.

  • Educational Video for PatientsOther

    Dialysis facilities will receive a ~10 minute educational video targeted to dialysis patients to explain the transplant process and allocation policy.

  • Educational WebinarOther

    Education for medical directors and facility staff about the kidney allocation policy will be discussed in a webinar and information will be hosted on a website for participants to access. The seminar will be roughly 45 minutes, and continuing medical education (CME) credits will be offered.

  • Standard CareOther

    Dialysis facilities will conduct standard or usual care and education regarding transplantation.

  • United Network for Organ Sharing (UNOS) PamphletOther

    Dialysis facility staff will be provided an educational pamphlet detailing the changes in the new kidney allocation policy .

Study groups in NCT02879812
Study groupRoleWhat they receive
Multi-Component InterventionExperimentalEnd Stage Renal Disease (ESRD) facilities will receive feedback reports containing facility specific data, an educational webinar for dialysis facility medical directors and staff, and an educational video for patients and staff.
Receives: Other: Performance Feedback Reports; Other: Educational Video for Staff; Other: Educational Video for Patients; Other: Educational Webinar; Other: United Network for Organ Sharing (UNOS) Pamphlet
Standard Care + PamphletActive comparatorEnd Stage Renal Disease (ESRD) facilities will conduct usual care and receive United Network for Organ Sharing (UNOS) educational pamphlets for staff.
Receives: Other: Standard Care; Other: United Network for Organ Sharing (UNOS) Pamphlet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Incident Patients Waitlisted

    The adjusted mean proportions of incident (new) patients waitlisted for kidney transplantation at study dialysis facilities, at the baseline and post-intervention time periods, were calculated. Incident patients are those who initiated dialysis treatment at study facilities during one of the study time periods. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Baseline (the twelve month period prior to the intervention), Post-intervention (the twelve month period after the intervention)

  2. Proportion of Black and White Incident Patients Waitlisted

    The adjusted mean proportions of Black versus White incident patients waitlisted for kidney transplantation at study dialysis facilities, at the baseline and post-intervention follow-up assessments, were calculated. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Baseline (the twelve month period prior to the intervention), Post-intervention (the twelve month period after the intervention)

  3. Proportion of Prevalent Patients Waitlisted During the Baseline Period

    The adjusted mean proportions of prevalent patients waitlisted for kidney transplantation at study dialysis facilities during the baseline time period were calculated. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Baseline (the twelve month period prior to the intervention)

  4. Proportion of Prevalent Patients Waitlisted During the Post-Intervention Time Period

    The adjusted mean proportions of prevalent patients waitlisted for kidney transplantation at study dialysis facilities during the post-intervention period were calculated. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Post-intervention (the twelve month period after the intervention)

  5. Proportion of Black and White Prevalent Patients Waitlisted During the Baseline Period

    Waitlisting disparity is assessed as the adjusted mean proportion of Black versus White prevalent patients waitlisted for kidney transplantation at study dialysis facilities during the baseline time period. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Baseline (the twelve month period prior to the intervention)

  6. Proportion of Black and White Prevalent Patients Waitlisted During the Post-Intervention Time Period

    Waitlisting disparity is assessed as the adjusted mean proportion of Black versus White prevalent patients waitlisted for kidney transplantation at study dialysis facilities during the post-intervention period. Mean proportions were adjusted for time and facility-level random effects.

    Measured: Post-intervention (the twelve month period after the intervention)

Secondary outcomes (4)
  1. Knowledge About the Kidney Allocation System

    Knowledge about the kidney allocation system was assessed using a survey among dialysis facility medical directors or nurse managers. The survey measured provider knowledge of Kidney Allocation System (KAS) and transplantation using a cumulative knowledge score ranging from 0 to 5, where 0 = least knowledge and 5 = highest level of knowledge (higher scores are preferable, indicating greater knowledge).

    Measured: Baseline, Immediately Post-intervention (3 months after the start of the intervention)

  2. Percentage of Facilities With Increases or No Change/Decreases in Staff Training

    Staff training about kidney transplant and the allocation system was assessed among dialysis facility medical directors or nurse managers by asking "what proportion of staff have you trained regarding the new kidney allocations system?" The staff training score was based on facility-level average percent and used a scale of 0 = 0% of staff trained, 1 = 1-20% of staff trained, 2 = 21-40% of staff trained, 3 = 41-60% of staff trained, 4 = 61-80% of staff trained, and 5 = 81-100% of staff trained. Facilities were grouped as either having an increase in the percentage of staff who were trained about KAS, or had no change or a decrease in the percentage of staff trained between the baseline and post-intervention follow-up at 3 months.

    Measured: Baseline, Immediately Post-intervention (3 months after the start of the intervention)

  3. Percentage of Facilities With Increases or No Change/Decreases in Patient Education

    Patient education about kidney transplant and the allocation system was assessed among dialysis facility medical directors or nurse managers by asking "what proportion of patients in this specific facility have you or your staff educated about kidney transplantation?" The patient education score was based on facility-level average percent and recorded as ordinal responses scored on a scale of 0 = 0% of patients educated, 1 = 1-20% of patients educated, 2 = 21-40% of patients educated, 3 = 41-60% of patients educated, 4 = 61-80% of patients educated, and 5 = 81-100% of patients educated. Facilities were grouped as either having an increase in the percentage of patients educated about KAS, or had no change or a decrease in the percentage of patients educated between the baseline and post-intervention follow-up at 3 months.

    Measured: Baseline, Immediately Post-intervention (3 months after the start of the intervention)

  4. Percentage of Facilities With Increases or No Change/Decreases in Intent to Refer Patients for Kidney Transplantation

    Change in referral practices were measured by asking dialysis facility medical directors or nurse managers about the estimated number of patients where were referred for kidney transplantation in that facility. The medical director or nurse manager was asked "since the beginning of the ASCENT quality improvement project (about 3 months ago), have you been referring more or fewer patients?" Possible responses were: more, same, fewer, or unsure. Facilities were grouped as either having an increase in the number of patients referred for transplant, or had no change or a decrease in the proportion of patients referred for transplant.

    Measured: Immediately Post-intervention (3 months after the start of the intervention)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Aug 2016 (estimated)
  2. Study startSep 2016
  3. Primary completion2 Aug 2019
  4. Study completion2 Aug 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
56,332 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02879812
Sponsor's protocol ID
IRB00081580
Other IDs
1R01MD010290-01
Acronym
ASCENT
Status last verified
Sep 2025
First submitted
23 Aug 2016
Last updated
7 Oct 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Urbanski M, Lee YH, Escoffery C, Buford J, Plantinga L, Pastan SO, Hamoda R, Blythe E, Patzer RE. Implementation of the ASCENT Trial to Improve Transplant Waitlisting Access. Kidney Int Rep. 2023 Nov 2;9(2):225-238. doi: 10.1016/j.ekir.2023.10.028. eCollection 2024 Feb.

    PubMed 38344743
  • Patzer RE, Smith K, Basu M, Gander J, Mohan S, Escoffery C, Plantinga L, Melanson T, Kalloo S, Green G, Berlin A, Renville G, Browne T, Turgeon N, Caponi S, Zhang R, Pastan S. The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity. Kidney Int Rep. 2017 May;2(3):433-441. doi: 10.1016/j.ekir.2017.02.002. Epub 2017 Feb 9.

    PubMed 28845470
  • Patzer RE, Zhang R, Buford J, McPherson L, Lee YH, Urbanski M, Li D, Wilk A, Paul S, Plantinga L, Escoffery C, Pastan SO. The ASCENT Intervention to Improve Access and Reduce Racial Inequalities in Kidney Waitlisting: A Randomized, Effectiveness-Implementation Trial. Clin J Am Soc Nephrol. 2023 Mar 1;18(3):374-382. doi: 10.2215/CJN.0000000000000071. Epub 2023 Feb 8.

    PubMed 36764664
  • Magua W, Basu M, Pastan SO, Kim JJ, Smith K, Gander J, Mohan S, Escoffery C, Plantinga LC, Melanson T, Garber MD, Patzer RE. Effect of the ASCENT Intervention to Increase Knowledge of Kidney Allocation Policy Changes Among Dialysis Providers. Kidney Int Rep. 2020 Jul 2;5(9):1422-1431. doi: 10.1016/j.ekir.2020.06.027. eCollection 2020 Sep.

    PubMed 32954067

Questions about this trial

What is this clinical trial studying?

A study testing Performance Feedback Reports, Educational Video for Staff and Educational Video for Patients in people with Kidney Disorders, run by Emory University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Incident Patients Waitlisted (time frame: Baseline (the twelve month period prior to the intervention), Post-intervention (the twelve month period after the intervention)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02879812, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2025.

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