Gender Disparities in Access to Pediatric Renal Transplantation in Europe: Data From the ESPN/ERA-EDTA Registry

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Julien HoganESPN/ERA-EDTA Registry

Abstract

Inequalities between genders in access to transplantation have been demonstrated. We aimed to validate this gender inequality in a large pediatric population and to investigate its causes. This cohort study included 6454 patients starting renal replacement therapy before 18 years old, in 35 countries participating in the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry. We used cumulative incidence competing risk and proportional hazards frailty models to study the time to receive a transplant and hierarchical logistic regression to investigate access to preemptive transplantation. Girls had a slower access to renal transplantation because of a 23% lower probability of receiving preemptive transplantation. We found a longer follow-up time before renal replacement therapy in boys compared with girls despite a similar estimated glomerular filtration rate at first appointment. Girls tend to progress faster toward end-stage renal disease than boys, which may contribute to a shorter time available for pretransplantation workup. Overall, medical factors explained only 70% of the gender difference. In Europe, girls have less access to preemptive transplantation...Continue Reading

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Citations

Mar 3, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Giorgina B PiccoliUNKNOWN World Kidney Day Steering Committee
Mar 13, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rukshana ShroffUNKNOWN European Society for Paediatric Nephrology Dialysis Working Group
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Aug 29, 2019·Transplantation·Claudie LapriseRuth Sapir-Pichhadze
Mar 1, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Stéphanie BonnéricJulien Hogan
Jun 26, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Cyrielle ParmentierUNKNOWN REIN Registry
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Dec 29, 2020·Frontiers in Pediatrics·Mercedes Lopez-GonzalezGema Ariceta
May 16, 2020·Néphrologie & thérapeutique·Maryvonne Hourmant, Valérie Chatelet

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