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Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2024

Lower access to kidney transplantation for women in France is not explained by comorbidities and social deprivation

Florian Bayer
Éric Daugas

Résumé

BACKGROUND: Access to kidney transplantation (KT) remains challenging for patients with end-stage kidney disease. This study assessed women’s access to KT in France by considering comorbidities and neighborhood social deprivation. METHODS: All incident 18-85-year-old patients starting dialysis in France between January 1, 2017 and December 31, 2019 were included. Three outcomes were assessed: (i) access to the KT waiting list after dialysis start, (ii) KT access after waitlisting, and (iii) KT access after dialysis start. Cox and Fine and Gray models were used. Gender-EDI and gender-age interactions were tested and analyses were performed among strata if required. RESULTS: 29,395 patients were included (35% of women). After adjusting for social deprivation and comorbidities, women were less likely to be waitlisted at 1 (adjHR: 0.91 [0.87-0.96]) and 3 years (adjHR: 0.87 [0.84-0.91]) post-dialysis initiation. This disparity concerned mainly ≥60-year-old women (adjHR: 0.76 [0.71-0.82] at 1 year and 0.75 [0.71-0.81] at 3 years). Access to KT, after 2 years of waitlisting was similar between genders. Access to KT was similar between genders at 3 years after dialysis start, but decreased for women after 4 years (adjHR: 0.93 [0.88-0.99]) and longer follow-up (adjHR: 0.90 [0.85-0.96]). CONCLUSIONS: In France, women are less likely to be waitlisted and undergo kidney transplantation. This is driven by the ≥60-year-old group and is not explained by comorbidities or social deprivation level.

Dates et versions

hal-04483609 , version 1 (29-02-2024)

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Latame Komla Adoli, Cécile Couchoud, Valérie Châtelet, Thierry Lobbedez, Florian Bayer, et al.. Lower access to kidney transplantation for women in France is not explained by comorbidities and social deprivation. Nephrology Dialysis Transplantation, 2024, Nephrology, Dialysis, Transplantation : Official Publication of the European, ⟨10.1093/ndt/gfae047⟩. ⟨hal-04483609⟩
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