Socioeconomic Inequalities in the Kidney Transplantation Process: A Registry-Based Study in Sweden

Transplantation Direct
Ye ZhangJohan Jarl

Abstract

Few studies have examined the association between individual-level socioeconomic status and access to kidney transplantation. This study aims to investigate the association between predialysis income and education, and access to (i) the kidney waitlist (first listing), and (ii) kidney transplantation conditional on waitlist placement. Adjustment will be made for a number of medical and nonmedical factors. The Swedish Renal Register was linked to national registers for adult patients in Sweden who started dialysis during 1995 to 2013. We employed Cox proportional hazards models. Nineteen per cent of patients were placed on the waitlist. Once on the waitlist, 80% received kidney transplantation. After adjusting for covariates, patients in the highest income quintile were found to have higher access to both the waitlist (hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.53-1.96) and kidney transplantation (HR, 1.33; 95% CI, 1.16-1.53) compared with patients in the lowest income quintile. Patients with higher education also had better access to the waitlist and kidney transplantation (HR, 2.16; 95% CI, 1.94-2.40; and HR, 1.16; 95% CI, 1.03-1.30, respectively) compared with patients with mandatory education. Socioeconomic sta...Continue Reading

References

Dec 4, 2003·BMJ : British Medical Journal·Gabriel C OniscuJohn L R Forsythe
Jan 27, 2005·Scandinavian Journal of Urology and Nephrology·S SchönJ Ahlmén
Apr 26, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Elke S SchaeffnerWolfgang C Winkelmayer
Jul 28, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M R SaundersG C Alexander
Nov 13, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M W KhattakA S Goldfarb-Rumyantzev
May 21, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Jesse D ScholdHerwig-Ulf Meier-Kriesche

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Citations

Feb 13, 2019·Transplantation·Anette MelkMarina Berenguer
Apr 19, 2021·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Isabelle DurieuManon Belhassen
May 7, 2021·Nature Reviews. Nephrology·Raymond VanholderGabriel C Oniscu

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