Social deprivation is associated with poor kidney transplantation outcome in children

被引:30
作者
Driollet, Benedicte [1 ]
Bayer, Florian [2 ]
Chatelet, Valerie [3 ]
Macher, Marie-Alice [2 ,4 ]
Salomon, Remi [5 ]
Ranchin, Bruno [6 ]
Roussey, Gwenaelle [7 ]
Lahoche, Annie [8 ]
Garaix, Florentine [9 ]
Decramer, Stephane [10 ]
Merieau, Elodie [11 ]
Fila, Marc [12 ]
Zaloszyc, Ariane [13 ]
Deschenes, Georges [4 ]
Valeri, Linda [14 ,15 ]
Launay, Ludivine [16 ]
Couchoud, Cecile [2 ]
Leffondre, Karen [1 ,17 ]
Harambat, Jerome [1 ,17 ,18 ]
机构
[1] Univ Bordeaux, ISPED, Ctr INSERM Bordeaux Populat Hlth Res U1219, Bordeaux, France
[2] Agence Biomed, La Plaine St Denis, France
[3] Caen Univ Hosp, Dept Nephrol, Caen, France
[4] Robert Debre Hosp, AP HP, Ctr Reference Malad Renales Rares Marhea, Pediat Nephrol Unit, Paris, France
[5] Paris Descartes Univ, Necker Enfants Malades Hosp, AP HP, Ctr Reference Malad Renales Rares Marhea,Pediat N, Paris, France
[6] Lyon Univ Hosp, Femme Mere Enfant Hosp, Ctr Reference Malad Renales Rares Nephrogones, Pediat Nephrol Unit, Bron, France
[7] Nantes Univ Hosp, Femme Enfant Adolescent Hosp, Pediat Nephrol Unit, Nantes, France
[8] Lille Univ Hosp, Jeanne de Flandre Hosp, Pediat Nephrol Unit, Lille, France
[9] Marseille Univ Hosp, Timone Enfants Hosp, Pediat Nephrol Unit, Marseille, France
[10] Toulouse Univ Hosp, Childrens Hosp, Ctr Reference Malad Renales Rares Sorare, Pediat Nephrol Unit, Toulouse, France
[11] Tours Univ Hosp, Clocheville Hosp, Pediat Nephrol Unit, Tours, France
[12] Montpellier Univ Hosp, Arnaud de Villeneuve Hosp, Ctr Reference Malad Renales Rares Sorare, Pediat Nephrol Unit, Montpellier, France
[13] Strasbourg Univ Hosp, Hautepierre Hosp, Pediat Nephrol Unit, Strasbourg, France
[14] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA
[15] McLean Hosp, Boston, MA USA
[16] INSERM UCN U1086 Anticipe, Ctr Lutte Canc Francois Baclesse, Caen, France
[17] INSERM, Clin Epidemiol CIC 1401, Bordeaux, France
[18] Bordeaux Univ Hosp, Pellegrin Enfants Hosp, Ctr Reference Malad Renales Rares Sorare, Pediat Nephrol Unit, Bordeaux, France
关键词
deprivation; end-stage kidney disease; French European Deprivation Index; kidney graft failure; pediatric kidney transplantation; STAGE RENAL-DISEASE; SOCIOECONOMIC-STATUS; MEDIATION ANALYSIS; INEQUALITIES; DISPARITIES; RECIPIENTS; SURVIVAL; ACCESS; ADHERENCE; FUTURE;
D O I
10.1016/j.kint.2019.05.011
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Socioeconomic status is an important determinant of health. Its impact on kidney transplantation outcome has been studied among adults but data in children are scarce, especially in Europe. Here, we investigate the association between the level of social deprivation (determined by the continuous score European Deprivation Index) and graft failure risk in pediatric kidney transplant recipients. All patients listed under 18 years of age who received a first kidney transplant between 2002 and 2014 in France were included. Of 1050 kidney transplant recipients (males 59%, median age at transplantation 13.2 years, preemptive transplantation 23%), 211 graft failures occurred within a median followup of 5.9 years. Thirty-seven percent of these patients belong to the most deprived quintile, suggesting that deprivation is more frequent in pediatric patients with end-stage kidney disease (ESKD) than in the general population. Five-and ten-year graft survival were 85% and 69%, respectively, in the most deprived quintile vs. 90% and 83%, respectively, in the least deprived quintile. At any time after transplantation, patients in the most deprived quintile had almost a two-fold higher hazard of graft failure compared with the least deprived quintile, after adjustment for age at renal replacement therapy, duration of dialysis, primary kidney disease, and rural/urban living environment (hazard ratio 1.99; 95% confidence interval 1.20-3.28). The hazard of graft failure did not differ significantly between girls and boys. Thus, our findings suggest a lower socioeconomic status is independently associated with poor graft outcome in pediatric kidney transplantation.
引用
收藏
页码:769 / 776
页数:8
相关论文
共 42 条
[1]   End stage renal disease risk and neighbourhood deprivation: A nationwide cohort study in Sweden [J].
Akrawi, Delshad Saleh ;
Li, Xinjun ;
Sundquist, Jan ;
Sundquist, Kristina ;
Zoller, Bengt .
EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2014, 25 (09) :853-859
[2]   Data Resource Profile: The European Union Statistics on Income and Living Conditions (EU-SILC) [J].
Arora, Vishal S. ;
Karanikolos, Marina ;
Clair, Amy ;
Reeves, Aaron ;
Stuckler, David ;
Mckee, Martin .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2015, 44 (02) :451-461
[3]   Kidney disease in children: latest advances and remaining challenges [J].
Bertram, John F. ;
Goldstein, Stuart L. ;
Pape, Lars ;
Schaefer, Franz ;
Shroff, Rukshana C. ;
Warady, Bradley A. .
NATURE REVIEWS NEPHROLOGY, 2016, 12 (03) :182-191
[4]   Early-Life Course Socioeconomic Factors and Chronic Kidney Disease [J].
Brophy, Patrick D. ;
Shoham, David A. ;
Charlton, Jennifer R. ;
Carmody, J. Bryan ;
Reidy, Kimberly J. ;
Harshman, Lyndsay ;
Segar, Jeffrey ;
Askenazi, David .
ADVANCES IN CHRONIC KIDNEY DISEASE, 2015, 22 (01) :16-23
[5]   Assessment of the ecological bias of seven aggregate social deprivation indices [J].
Bryere, Josephine ;
Pornet, Carole ;
Copin, Nane ;
Launay, Ludivine ;
Gusto, Gaelle ;
Grosclaude, Pascale ;
Delpierre, Cyrille ;
Lang, Thierry ;
Lantieri, Olivier ;
Dejardin, Olivier ;
Launoy, Guy .
BMC PUBLIC HEALTH, 2017, 17
[6]   Socioeconomic environment and cancer incidence: a French population-based study in Normandy [J].
Bryere, Josephine ;
Dejardin, Olivier ;
Bouvier, Veronique ;
Colonna, Marc ;
Guizard, Anne-Valerie ;
Troussard, Xavier ;
Pornet, Carole ;
Galateau-Salle, Francoise ;
Bara, Simona ;
Launay, Ludivine ;
Guittet, Lydia ;
Launoy, Guy .
BMC CANCER, 2014, 14
[7]   Renal transplantation outcome and social deprivation in the French healthcare system: a cohort study using the European Deprivation Index [J].
Chatelet, Valerie ;
Bayat-Makoei, Sahar ;
Vigneau, Cecile ;
Launoy, Guy ;
Lobbedez, Thierry .
TRANSPLANT INTERNATIONAL, 2018, 31 (10) :1089-1098
[8]   The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France [J].
Couchoud, C ;
Stengel, B ;
Landais, P ;
Aldigier, JC ;
de Cornelissen, F ;
Dabot, C ;
Maheut, H ;
Joyeux, V ;
Kessler, M ;
Labeeuw, M ;
Isnard, H ;
Jacquelinet, C .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2006, 21 (02) :411-418
[9]   Poverty, Race, and CKD in a Racially and Socioeconomically Diverse Urban Population [J].
Crews, Deidra C. ;
Charles, Raquel F. ;
Evans, Michele K. ;
Zonderman, Alan B. ;
Powe, Neil R. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2010, 55 (06) :992-1000
[10]   Adherence to the immunosuppressive regimen in pediatric kidney transplant recipients: A systematic review [J].
Dobbels, F. ;
Ruppar, T. ;
De Geest, S. ;
Decorte, A. ;
Van Damme-Lombaerts, R. ;
Fine, R. N. .
PEDIATRIC TRANSPLANTATION, 2010, 14 (05) :603-613