| Title |
The impact of socioeconomic status and geographic remoteness on access to pre-emptive kidney transplantation and transplant outcomes among children
|
|---|---|
| Published in |
Pediatric Nephrology, December 2015
|
| DOI | 10.1007/s00467-015-3279-z |
| Pubmed ID | |
| Authors |
Anna Francis, Madeleine Didsbury, Wai H. Lim, Siah Kim, Sarah White, Jonathan C. Craig, Germaine Wong |
| Abstract |
Low socioeconomic status (SES) and geographic disparity have been associated with worse outcomes and poorer access to pre-emptive transplantation in the adult end-stage kidney disease (ESKD) population, but little is known about their impact in children with ESKD. The aim of our study was to determine whether access to pre-emptive transplantation and transplant outcomes differ according to SES and geographic remoteness in Australia. Using data from the Australia and New Zealand Dialysis and Transplant Registry (1993-2012), we compared access to pre-emptive transplantation, the risk of acute rejection and graft failure, based on SES and geographic remoteness among Australian children with ESKD (≤18 years), using adjusted logistic and Cox proportional hazard modelling. Of the 768 children who commenced renal replacement therapy, 389 (50.5 %) received living donor kidney transplants and 28.5 % of these (111/389) were pre-emptive. There was no significant association between SES quintiles and access to pre-emptive transplantation, acute rejection or allograft failure. Children residing in regional or remote areas were 35 % less likely to receive a pre-emptive transplant compared to those living in major cities [adjusted odds ratio (OR) 0.65, 95 % confidence interval (CI) 0.45-1.0]. There was no significant association between geographic disparity and acute rejection (adjusted OR 1.03, 95 % CI 0.68-1.57) or graft loss (adjusted hazard ratio 1.05, 95 % CI 0.74-1.41). In Australia, children from regional or remote regions are much less likely to receive pre-emptive kidney transplantation. Strategies such as improved access to nephrology services through expanding the scope of outreach clinics, and support for regional paediatricians to promote early referral may ameliorate this inequity. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 42 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 17% |
| Other | 5 | 12% |
| Student > Bachelor | 5 | 12% |
| Student > Ph. D. Student | 4 | 10% |
| Student > Doctoral Student | 3 | 7% |
| Other | 5 | 12% |
| Unknown | 13 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 40% |
| Social Sciences | 4 | 10% |
| Economics, Econometrics and Finance | 2 | 5% |
| Psychology | 2 | 5% |
| Nursing and Health Professions | 1 | 2% |
| Other | 4 | 10% |
| Unknown | 12 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 December 2015.
All research outputs
#18,433,196
of 22,836,570 outputs
Outputs from Pediatric Nephrology
#3,130
of 3,543 outputs
Outputs of similar age
#281,170
of 389,451 outputs
Outputs of similar age from Pediatric Nephrology
#34
of 47 outputs
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