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Article Dans Une Revue Journal of Clinical Epidemiology Année : 2023

Social deprivation reduced registration for kidney transplantation through markers of nephrological care: a mediation analysis

Résumé

OBJECTIVES: We assessed the direct and indirect effect of social deprivation mediated by modifiable markers of nephrological follow-up on registration on the renal transplantation waiting-list. STUDY DESIGN AND SETTINGS: From the Renal Epidemiology and Information Network, we included French incident dialysis patients eligible for a registration evaluation between January 2017 and June 2018. Mediation analyses were conducted to assess effects of social deprivation estimated by quintile 5 (Q5) of the European Deprivation Index on registration defined as wait-listing at dialysis start or within the first 6 months. RESULTS: Among the 11655 included patients, 2410 were registered. Q5 had a direct effect on registration (OR 0.82 [0.80-0.84]) and an indirect effect mediated by emergency start dialysis (OR 0.97 [0.97-0.98]), hemoglobin < 11 g/dL and/or lack of EPO (OR 0.96 [0.96-0.96]) and albumin < 30 g/L (OR 0.98 [0.98-0.99]). CONCLUSION: Social deprivation was directly associated with a lower registration on the renal transplantation waiting-list but its effect was also mediated by markers of nephrological care, suggesting that improving the follow-up of the most deprived patients should help to reduce disparities in access to transplantation.
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Dates et versions

hal-04062024 , version 1 (15-05-2023)

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Paternité - Pas d'utilisation commerciale

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Eve Calvar, Ludivine Launay, Sahar Bayat, Marc Bauwens, Mathilde Lassalle, et al.. Social deprivation reduced registration for kidney transplantation through markers of nephrological care: a mediation analysis. Journal of Clinical Epidemiology, 2023, 157, pp.92-101. ⟨10.1016/j.jclinepi.2023.03.005⟩. ⟨hal-04062024⟩
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