Sarah Kizilbash, Chung-Ii Wi, Madison Roy, Warren T McKinney, Sandra Amaral, Samy Riad, Young Juhn
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引用次数: 0
Abstract
Background: Preemptive kidney transplantation in children is associated with better patient and graft survival compared to transplants following dialysis. However, preemptive kidney transplantation rates in children remain low. This study aimed to evaluate the effect of socioeconomic status (SES) on preemptive transplantation in children.
Methods: Our study included 173 Minnesota-resident pediatric kidney transplant recipients (<18 years) transplanted at the University of Minnesota from 2010-2020. Using the HOUSES index, a validated, individual SES measure based on housing units categorized into quartiles (Q1: lower SES; Q2-Q4: higher SES), we applied mixed-effects multivariable logistic models to examine the effects of HOUSES on preemptive kidney transplants and pretransplant dialysis duration.
Results: Of 173 pediatric kidney transplant recipients, 46 (26.6%) received a preemptive transplant, and of 109 recipients with dialysis duration data, 39 (35.8%) received dialysis for >1 year. After adjusting for age at kidney failure, sex, donor type, insurance type, and underlying cause of kidney failure, we observed significantly lower odds of preemptive transplantation among Q1 recipients compared to Q2-4 recipients (Adjusted odds ratio [aOR]: 0.31; 95% CI: 0.11, 0.90; p=0.03).
Conclusions: Using the HOUSES index, we found significant socioeconomic disparities in preemptive kidney transplantation rates among children.
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