Social deprivation is associated with poor kidney transplantation outcome in children

Driollet, Bénédicte; Bayer, Florian; Châtelet, Valérie; Macher, Marie‐Alice; Salomon, Rémi; Ranchin, Bruno; Roussey, G.; Lahoche, Annie; Garaix, Florentine; Decramer, Stéphane; Mérieau, Elodie; Fila, Marc; Zaloszyc, Ariane; Deschênes, Georges; Valeri, Linda; Launay, Ludivine; Couchoud, Cécile; Leffondré, Karen; Harambat, Jérôme

doi:10.1016/j.kint.2019.05.011

Cited by 27 publications

(28 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This includes medications, equipment for peritoneal J o u r n a l P r e -p r o o f 5 dialysis, travelling to the hospital, psycho-social support, school assistance, which implies not out-ofpocket expenses for patients. While we found disparities in kidney graft survival in this specific context 8 , it is questionable whether socio-economic disparities also exist for access to pre-emptive kidney transplantation, or for the modality of dialysis initiation.…”

Section: Introductioncontrasting

confidence: 55%

Social Deprivation Is Associated With Lower Access to Pre-emptive Kidney Transplantation and More Urgent-Start Dialysis in the Pediatric Population

Driollet

Bayer

Kwon

et al. 2022

Kidney International Reports

Self Cite

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Section: Introductioncontrasting

confidence: 55%

Social Deprivation Is Associated With Lower Access to Pre-emptive Kidney Transplantation and More Urgent-Start Dialysis in the Pediatric Population

Driollet

Bayer

Kwon

et al. 2022

Kidney International Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…There is also evidence that health care utilization differs by socioeconomic status, with UK children from less-affluent areas having higher rates of primary care and emergency department use (38,39), longer hospital stays (40), and fewer preventative health care consultations (38). For children with kidney failure, poorer outcomes such as greater risk of graft loss are seen among children from deprived areas (41,42). The association between access to specialist kidney care is, however, inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Associations between Deprivation, Geographic Location, and Access to Pediatric Kidney Care in the United Kingdom

Plumb

Sinha

Casula

et al. 2021

CJASN

View full text Add to dashboard Cite

Background and objectivesPre-emptive kidney transplantation is advocated as best practice for children with kidney failure who are transplant eligible; however, it is limited by late presentation. We aimed to determine whether socioeconomic deprivation and/or geographic location (distance to the center and rural/urban residence) are associated with late presentation, and to what degree these factors could explain differences in accessing pre-emptive transplantation.Design, setting, participants, & measurementsA cohort study using prospectively collected United Kingdom Renal Registry and National Health Service Blood and Transplant data from January 1, 1996 to December 31, 2016 was performed. We included children aged >3 months to ≤16 years at the start of KRT. Multivariable logistic regression models were used to determine associations between the above exposures and our outcomes: late presentation (defined as starting KRT within 90 days of first nephrology review) and pre-emptive transplantation, with a priori specified covariates.ResultsAnalysis was performed on 2160 children (41% females), with a median age of 3.8 years (interquartile range, 0.2–9.9 years) at first nephrology review. Excluding missing data, 478 were late presenters (24%); 565 (26%) underwent pre-emptive transplantation, none of whom were late presenting. No association was seen between distance or socioeconomic deprivation with late presentation, in crude or adjusted analyses. Excluding late presenters, greater area affluence was associated with higher odds of pre-emptive transplantation, (odds ratio, 1.20 per quintile greater affluence; 95% confidence interval, 1.10 to 1.31), with children of South Asian (odds ratio, 0.52; 95% confidence interval, 0.36 to 0.76) or Black ethnicity (odds ratio, 0.31; 95% confidence interval, 0.12 to 0.80) less likely to receive one. A longer distance to the center was associated with pre-emptive transplantation on crude analyses; however, this relationship was attenuated (odds ratio, 1.02 per 10 km; 95% confidence interval, 0.99 to 1.05) in the multivariable model.ConclusionsSocioeconomic deprivation or geographic location are not associated with late presentation in children in the United Kingdom. Geographic location was not independently associated with pre-emptive transplantation; however, children from more affluent areas were more likely to receive a pre-emptive transplant.

show abstract

“…It is likely that the impact of neighborhood deprivation on outcomes following liver transplant is complex and may affect both adherence and graft survival 47 which could further confound the assessment of nonadherence on long-term graft survival. Certainly, data across diseases and patient populations indicate that neighborhood contextual factors are important to one's health 48,49 and may be important contributors to effective selfmanagement.…”

Section: Discussionmentioning

confidence: 99%

Association Between Neighborhood-level Socioeconomic Deprivation and the Medication Level Variability Index for Children Following Liver Transplantation

et al. 2020

View full text Add to dashboard Cite

Background: Neighborhood socioeconomic deprivation is associated with adverse health outcomes. We sought to determine if neighborhood socioeconomic deprivation was associated with adherence to immunosuppressive medications after liver transplantation. Methods:We conducted a secondary analysis of a multicenter, prospective cohort of children enrolled in the Medication Adherence in children who had a Liver Transplant study (enrollment 2010-2013). Participants (N=271) received a liver transplant ≥1 year prior to enrollment and were subsequently treated with tacrolimus. The primary exposure, connected to geocoded participant home addresses, was a neighborhood socioeconomic deprivation index (range 0-1, higher indicates more deprivation). The primary outcome was the Medication Level Variability Index (MLVI), a surrogate measure of adherence to immunosuppression in pediatric liver transplant recipients. Higher MVLI indicates worse adherence behavior; values ≥2.5 are predictive of late allograft rejection.Findings: There was a 5% increase in MLVI for each 0.1 increase in deprivation index (95%CI: −1%, 11%, p=0.08). Roughly 24% of participants from the most deprived quartile had an MLVI

show abstract

Social deprivation is associated with poor kidney transplantation outcome in children

Cited by 27 publications

References 43 publications

Social Deprivation Is Associated With Lower Access to Pre-emptive Kidney Transplantation and More Urgent-Start Dialysis in the Pediatric Population

Social Deprivation Is Associated With Lower Access to Pre-emptive Kidney Transplantation and More Urgent-Start Dialysis in the Pediatric Population

Associations between Deprivation, Geographic Location, and Access to Pediatric Kidney Care in the United Kingdom

Association Between Neighborhood-level Socioeconomic Deprivation and the Medication Level Variability Index for Children Following Liver Transplantation

Contact Info

Product

Resources

About