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2017 ; 14
(2
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Are There Inequities in Treatment of End-Stage Renal Disease in Sweden? A
Longitudinal Register-Based Study on Socioeconomic Status-Related Access to
Kidney Transplantation
#MMPMID28134798
Zhang Y
; Jarl J
; Gerdtham UG
Int J Environ Res Public Health
2017[Jan]; 14
(2
): ä PMID28134798
show ga
Socioeconomic status-related factors have been associated with access to kidney
transplantation, yet few studies have investigated both individual income and
education as determinates of access to kidney transplantation. Therefore, this
study aims to explore the effects of both individual income and education on
access to kidney transplantation, controlling for both medical and non-medical
factors. We linked the Swedish Renal Register to national registers for a sample
of adult patients who started Renal Replacement Therapy (RRT) in Sweden between 1
January 1995, and 31 December 2013. Using uni- and multivariate logistic models,
we studied the association between pre-RRT income and education and likelihood of
receiving kidney transplantation. For non-pre-emptive transplantation patients,
we also used multivariate Cox proportional hazards regression analysis to assess
the association between treatment and socioeconomic factors. Among the 16,215
patients in the sample, 27% had received kidney transplantation by the end of
2013. After adjusting for covariates, the highest income group had more than
three times the chance of accessing kidney transplantation compared with patients
in the lowest income group (odds ratio (OR): 3.22; 95% confidence interval (CI):
2.73-3.80). Patients with college education had more than three times higher
chance of access to kidney transplantation compared with patients with mandatory
education (OR: 3.18; 95% CI: 2.77-3.66). Neither living in the county of the
transplantation center nor gender was shown to have any effect on the likelihood
of receiving kidney transplantation. For non-pre-emptive transplantation
patients, the results from Cox models were similar with what we got from logistic
models. Sensitive analyses showed that results were not sensitive to different
conditions. Overall, socioeconomic status-related inequities exist in access to
kidney transplantation in Sweden. Additional studies are needed to explore the
possible mechanisms and strategies to mitigate these inequities.
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Female
[MESH]
|Health Services Accessibility/*standards
[MESH]
|Healthcare Disparities/*standards/*statistics & numerical data
[MESH]
|Humans
[MESH]
|Kidney Failure, Chronic/*surgery
[MESH]
|Kidney Transplantation/*standards/*statistics & numerical data
[MESH]