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Results in the ESPN/ERA-EDTA Registry suggest disparities in access to kidney transplantation but little variation in graft survival of children across Europe
M. Bonthuis, L. Cuperus, NC. Chesnaye, S. Akman, AA. Melgar, S. Baiko, AH. Bouts, O. Boyer, K. Dimitrova, CD. Carmo, R. Grenda, J. Heaf, T. Jahnukainen, A. Jankauskiene, L. Kaltenegger, M. Kostic, SD. Marks, A. Mitsioni, G. Novljan, R. Palsson,...
Language English Country United States
Document type Journal Article
NLK
Freely Accessible Science Journals
from 1972
Open Access Digital Library
from 1972-01-01
- MeSH
- Kidney Failure, Chronic * epidemiology surgery MeSH
- Child MeSH
- Edetic Acid MeSH
- Humans MeSH
- Graft Survival MeSH
- Registries MeSH
- Kidney Transplantation * adverse effects MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
One of the main objectives of the European health policy framework is to ensure equitable access to high-quality health services across Europe. Here we examined country-specific kidney transplantation and graft failure rates in children and explore their country- and patient-level determinants. Patients under 20 years of age initiating kidney replacement therapy from January 2007 through December 2015 in 37 European countries participating in the ESPN/ERA-EDTA Registry were included in the analyses. Countries were categorized as low-, middle-, and high-income based on gross domestic product. At five years of follow-up, 4326 of 6909 children on kidney replacement therapy received their first kidney transplant. Overall median time from kidney replacement therapy start to first kidney transplantation was 1.4 (inter quartile range 0.3-4.3) years. The five-year kidney transplantation probability was 48.8% (95% confidence interval: 45.9-51.7%) in low-income, 76.3% (72.8-79.5%) in middle-income and 92.3% (91.0-93.4%) in high-income countries and was strongly associated with macro-economic factors. Gross domestic product alone explained 67% of the international variation in transplantation rates. Compared with high-income countries, kidney transplantation was 76% less likely to be performed in low-income and 58% less likely in middle-income countries. Overall five-year graft survival in Europe was 88% and showed little variation across countries. Thus, despite large disparities transplantation access across Europe, graft failure rates were relatively similar. Hence, graft survival in low-risk transplant recipients from lower-income countries seems as good as graft survival among all (low-, medium-, and high-risk) graft recipients from high-income countries.
Center for Pediatrics Vilnius University Vilnius Lithuania
Department of Medicine Zealand University Hospital Roskilde Denmark
Department of Nephrology P and A Kyriakou Children's Hospital Athens Greece
Department of Pediatric Nephrology Akdeniz University Faculty of Medicine Antalya Turkey
Department of Pediatric Nephrology Hospital Pediátrico de Coimbra Coimbra Portugal
Department of Pediatric Nephrology La Paz Children's Hospital Madrid Spain
Department of Pediatric Nephrology University Hospital Antwerp Antwerp Belgium
Department of Pediatric Nephrology University Medical Center Ljubljana Slovenia
Department of Pediatrics 1 University Children's Hospital Heidelberg Germany
Department of Pediatrics Belarusian State Medical University Minsk Belarus
Department of Pediatrics Faculty of Medicine University of Debrecen Debrecen Hungary
Divsion of Pedatrics and Adolescent Medicine Oslo University Hospital Rikshospitalet Norway
Faculty of Medicine School of Health Sciences University of Iceland Reykjavik Iceland
Faculty of Medicine University of Ljubljana Slovenia
Medical Faculty University of Belgrade Belgrade Serbia
Pediatric Department Children's Hospital Comenius University Bratislava Slovakia
Pediatric Nephrology and Dialysis Unit Pediatric Hospital Giovanni XXIII Bari Italy
University Children's Hospital Nephrology and Urology Departments Belgrade Serbia
References provided by Crossref.org
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