Geographic variation in kidney failure and transplantation in Aotearoa New Zealand: A population-based data linkage study.

IF 2.4 4区医学 Q2 UROLOGY & NEPHROLOGY

Nephrology Pub Date : 2024-12-01 Epub Date: 2024-10-28 DOI:10.1111/nep.14409

Johanna M Birrell, Angela C Webster, Nicholas B Cross, Tim Driscoll, Heather Dunckley, Ben Beaglehole, Ian Dittmer, Curtis Walker, Merryn Jones, John Irvine, Melanie L Wyld, Kate R Wyburn, Nicole L De La Mata

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引用次数: 0

Abstract

Aim: This study aimed to describe the epidemiology of kidney replacement therapy (KRT) in Aotearoa New Zealand and assess the impact of residential location on access to kidney transplantation.

Methods: AcceSS and Equity in Transplantation (ASSET), a health-linked data platform, was used to identify people commencing KRT in New Zealand from 2006 to 2019 and analyse regional epidemiology. Health services were classified as 'transplanting', 'intermediate' or 'remote' depending on their degree of separation from a transplant centre. Multiple logistic regression modelling was used to assess the predictors of deceased donor waitlisting or living donor transplantation within 6 months after starting KRT. Web-based mapping software was used to develop interactive geospatial maps.

Results: The cohort was 7704 people newly starting KRT. Living in an intermediate [odds ratio (OR): 0.73 (95% confidence interval (CI): 0.61-0.88)] or remote [OR: 0.38 (95% CI: 0.27-0.54)) region and Māori (OR: 0.35 (95% CI: 0.28-0.44)], Pacific [OR: 0.32 (95% CI: 0.24-0.42)) and Asian (OR: 0.66 (95% CI: 0.50-0.87)] ethnicity were associated with a decreased likelihood of timely waitlisting or transplantation. Regional maps can be explored here.

Conclusion: There is marked geospatial and ethnic variation in the epidemiology of kidney failure and access to kidney transplantation across New Zealand. Geospatial mapping of kidney failure epidemiology and transplantation outcomes can provide opportunities to direct resources towards populations at greatest need.

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新西兰奥特亚罗瓦肾衰竭和移植的地域差异：基于人口的数据链接研究。

目的：本研究旨在描述新西兰奥特亚罗瓦地区肾脏替代疗法（KRT）的流行病学，并评估居住地对肾脏移植机会的影响：方法：利用与健康相关的数据平台 "移植中的公平与公正"（AcceSS and Equity in Transplantation，ASSET）来识别2006年至2019年期间在新西兰开始KRT治疗的患者，并分析地区流行病学。根据医疗服务与移植中心的分离程度，医疗服务被分为 "移植"、"中间 "或 "偏远"。采用多元逻辑回归模型来评估开始 KRT 后 6 个月内等待死亡供体或活体供体移植的预测因素。使用网络制图软件开发了交互式地理空间地图：队列中有 7704 名新开始 KRT 的患者。居住在中间地区[几率比（OR）：0.73（95% 置信区间（CI）：0.61-0.88）]或偏远地区[OR：0.38（95% CI：0.27-0.54）]以及毛利人（OR：0.35（95% CI：0.28-0.44）]、太平洋[OR：0.32（95% CI：0.24-0.42）]和亚洲（OR：0.66（95% CI：0.50-0.87）]种族与及时候诊或移植的可能性降低有关。可在此处查看区域地图：结论：在新西兰，肾衰竭的流行病学和接受肾移植的机会存在明显的地理空间和种族差异。肾衰竭流行病学和移植结果的地理空间分布图可以提供机会，将资源导向最需要的人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephrology 医学-泌尿学与肾脏学

CiteScore

4.50

自引率

4.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Nephrology is published eight times per year by the Asian Pacific Society of Nephrology. It has a special emphasis on the needs of Clinical Nephrologists and those in developing countries. The journal publishes reviews and papers of international interest describing original research concerned with clinical and experimental aspects of nephrology.