BACKGROUND: Socio-economic disadvantage has been linked to higher incidence of end-stage kidney disease in developed countries. Associations between socio-economic status (SES) and incidence of renal replacement therapy (RRT) have not been explored for different kidney diseases, genders or age groups in a country with universal access to healthcare. METHODS: We investigated the incidence of non-indigenous patients commencing RRT in Australia in 2000-09, using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Patient postcodes were grouped into deciles using a standard SES index. We analysed incidence by five groups of kidney diseases, age groups, gender and geographic remoteness. RESULTS: Incidence of RRT decreased with increasing area advantage. Differences were most evident for the most disadvantaged areas [markedly increased burden; incident rate ratio (IRR) 1.27; 95% confidence interval (CI) 1.18-1.38] and most advantaged decile (decreased burden, IRR 0.76; 95% CI 0.72-0.81), compared with decile 5. Patients with diabetic nephropathy showed the greatest disparities: residents of the most disadvantaged decile were 2.38 (95% CI 2.09-2.71) times more at risk than the most advantaged decile. Congenital and genetic kidney diseases showed lesser gradients-the most disadvantaged decile was 1.28 times (95% CI 0.98-1.68) more at risk. SES was not associated with incidence for patients older than 69 years. DISCUSSION: These SES gradients existed, despite all Australians having access to healthcare. Diseases associated with lifestyle show the greatest gradients with SES.
BACKGROUND: Socio-economic disadvantage has been linked to higher incidence of end-stage kidney disease in developed countries. Associations between socio-economic status (SES) and incidence of renal replacement therapy (RRT) have not been explored for different kidney diseases, genders or age groups in a country with universal access to healthcare. METHODS: We investigated the incidence of non-indigenous patients commencing RRT in Australia in 2000-09, using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Patient postcodes were grouped into deciles using a standard SES index. We analysed incidence by five groups of kidney diseases, age groups, gender and geographic remoteness. RESULTS: Incidence of RRT decreased with increasing area advantage. Differences were most evident for the most disadvantaged areas [markedly increased burden; incident rate ratio (IRR) 1.27; 95% confidence interval (CI) 1.18-1.38] and most advantaged decile (decreased burden, IRR 0.76; 95% CI 0.72-0.81), compared with decile 5. Patients with diabetic nephropathy showed the greatest disparities: residents of the most disadvantaged decile were 2.38 (95% CI 2.09-2.71) times more at risk than the most advantaged decile. Congenital and genetic kidney diseases showed lesser gradients-the most disadvantaged decile was 1.28 times (95% CI 0.98-1.68) more at risk. SES was not associated with incidence for patients older than 69 years. DISCUSSION: These SES gradients existed, despite all Australians having access to healthcare. Diseases associated with lifestyle show the greatest gradients with SES.
Authors: Wen Tang; Blair Grace; Stephen P McDonald; Carmel M Hawley; Sunil V Badve; Neil C Boudville; Fiona G Brown; Philip A Clayton; David W Johnson Journal: Perit Dial Int Date: 2014-02-04 Impact factor: 1.756
Authors: Deidra C Crews; Orlando M Gutiérrez; Stacey A Fedewa; Jean-Christophe Luthi; David Shoham; Suzanne E Judd; Neil R Powe; William M McClellan Journal: BMC Nephrol Date: 2014-12-04 Impact factor: 2.388
Authors: Suceena Alexander; Sanjiv Jasuja; Maurizio Gallieni; Manisha Sahay; Devender S Rana; Vivekanand Jha; Shalini Verma; Raja Ramachandran; Vinant Bhargava; Gaurav Sagar; Anupam Bahl; Mamun Mostafi; Jayakrishnan K Pisharam; Sydney C W Tang; Chakko Jacob; Atma Gunawan; Goh B Leong; Khin T Thwin; Rajendra K Agrawal; Kriengsak Vareesangthip; Roberto Tanchanco; Lina H L Choong; Chula Herath; Chih C Lin; Nguyen T Cuong; Ha P Haian; Syed F Akhtar; Ali Alsahow; Mohan M Rajapurkar; Vijay Kher; Hemant Mehta; Anil K Bhalla; Umesh B Khanna; Deepak S Ray; Sonika Puri; Himanshu Jain; Aida Lydia; Tushar Vachharajani Journal: Int J Nephrol Date: 2021-05-06