科研之友
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Samuel SM, Hemmelgarn B, Nettel-Aguirre A, Foster B, Soo A, Alexander RT, Tonelli M, Pediatric Renal Outcomes Canada Group. Association between residence location and likelihood of transplantation among pediatric dialysis patients. Abstract: Many children with ESRD reside far from a kidney transplant center. It is unknown whether this geographical barrier affects likelihood of transplantation. We used data from a national ESRD database. Patients =18 yr old who started renal replacement in nine Canadian provinces during 19922007 were followed until death or last contact. Primary outcome was kidney transplantation (living or deceased donor). Distance between nearest pediatric transplant center and each patients residence was categorized as: %26lt;50, 50 to %26lt;150, 150 to %26lt;300, and =300 km. Using survival analysis, we compared likelihood of transplantation between whites and non-whites living in various distance categories. Among 728 patients, 52.2% were males and 62.5% were whites. Compared to white children living %26lt;50 km from a transplant center, white (HR, 0.73; 95% CI, 0.560.95) and non-white (HR, 0.66; 95% CI, 0.480.92) children living =300 km away were less likely to receive a transplant. Non-white children living %26lt;50 km away (HR, 0.59; 95% CI 0, 450.78) were also less likely to receive a transplant compared to otherwise similar whites living %26lt;50 km away. Although equitable access to transplantation by residence location is observed among remote-dwelling adults with ESRD, white and non-white children with ESRD living =300 km from a transplant center were less likely to receive transplants.
- 出版日期2012-11
