Outcome-dependent geographic and individual variations in the access to renal transplantation in incident dialysed patients: a French nationwide cohort study - Archive ouverte HAL Access content directly
Journal Articles Transplant International Year : 2019

Outcome-dependent geographic and individual variations in the access to renal transplantation in incident dialysed patients: a French nationwide cohort study

(1, 2) , , (3) , (4, 3) , (5) , (6) , (7, 8) , (1, 2)
1
2
3
4
5
6
7
8

Abstract

This study investigated geographic variations of access to renal transplantation using three outcomes (access to the transplant waiting list, access to renal transplantation after waitlisting and access to renal transplantation after dialysis start). Associations of patient-related and regional variables with the studied outcomes were assessed using a Cox shared frailty model and a Fine and Gray model. At the study endpoint (December 31, 2015), 26.3% of all 18-90-year-old patients who started dialysis in the 22 mainland and 4 overseas French regions in 2012 (n=9312) were waitlisted and 15.1% received a kidney transplant. The geographic disparities of access to renal transplantation varied according to the studied outcome. Patients from the Ile-de-France region had the highest probability of being waitlisted, but were less likely to receive a kidney transplant. Two regional factors were associated with the access to the waiting list and to renal transplantation from dialysis start the incidence of preemptive kidney transplantation and of ESRD. The use of different outcomes to evaluate access to kidney transplantation could help healthcare policy-makers to select the most appropriate interventions for each region in order to reduce treatment disparities.
Fichier principal
Vignette du fichier
Outcome‐dependent geographic and individual variations_accepted.pdf (548.22 Ko) Télécharger le fichier
Origin : Files produced by the author(s)
Loading...

Dates and versions

hal-01940385 , version 1 (25-01-2019)

Identifiers

Cite

Adélaide Pladys, Camille Morival, Cécile Couchoud, Christian Jacquelinet, Emmanuelle Laurain, et al.. Outcome-dependent geographic and individual variations in the access to renal transplantation in incident dialysed patients: a French nationwide cohort study. Transplant International, 2019, 32 (4), pp.369-386. ⟨10.1111/tri.13376⟩. ⟨hal-01940385⟩
112 View
156 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More