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Social Deprivation and Incidence of Pediatric Kidney Failure in France.
Driollet, Bénédicte; Couchoud, Cécile; Bacchetta, Justine; Boyer, Olivia; Hogan, Julien; Morin, Denis; Nobili, François; Tsimaratos, Michel; Bérard, Etienne; Bayer, Florian; Launay, Ludivine; Leffondré, Karen; Harambat, Jérôme.
Afiliación
  • Driollet B; University of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France.
  • Couchoud C; INSERM, Clinical Investigation Center-Clinical Epidemiology CIC-1401, Bordeaux, France.
  • Bacchetta J; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada.
  • Boyer O; REIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, France.
  • Hogan J; Pediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Nephrogones, Femme Mère Enfants Hospital, Hospices Civils de Lyon, Bron, France.
  • Morin D; Pediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares MARHEA, Necker-Enfants Malades Hospital, Imagine Institute, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • Nobili F; Pediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Marhea, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • Tsimaratos M; Pediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Sorare, Arnaud de Villeneuve Hospital, Montpellier University Hospital, Montpellier, France.
  • Bérard E; Department of Pediatrics, Besançon University Hospital, Besançon, France.
  • Bayer F; REIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, France.
  • Launay L; Pediatric Nephrology Unit, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
  • Leffondré K; Department of Pediatrics, Nice University Hospital, Nice, France.
  • Harambat J; REIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, France.
Kidney Int Rep ; 9(7): 2269-2277, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39081742
ABSTRACT

Introduction:

Approximately 8 per million children and young adults aged < 20 years initiate kidney replacement therapy (KRT) per year in France. We hypothesize that social deprivation could be a determinant of childhood-onset kidney failure. The objective of this study was to estimate the incidence of pediatric KRT in France according to the level of social deprivation.

Methods:

All patients < 20 years who initiated KRT from 2010 to 2015 in metropolitan France were included. Data were collected from the comprehensive French registry of KRT French Renal Epidemiology and Information network (REIN). We used a validated ecological index to assess social deprivation, the 2011 French version of the European Deprivation Index (EDI). We estimated the age standardized incidence rates according to the quintiles of EDI using direct standardization and incidence rate ratio using Poisson regression.

Results:

We included 672 children with kidney failure (58.6% males, 30.7% with glomerular or vascular disease, 43.3% starting KRT between 11 and 17 years). 38.8% were from the most deprived areas (quintile 5 of EDI). The age standardized incidence rate increased with quintile of EDI, from 5.45 (95% confidence interval [CI] = 4.25-6.64) per million children per year in the least deprived quintile to 8.46 (95% CI = 7.41-9.51) in the most deprived quintile of EDI (incidence rates ratio Q5 vs. Q1 1.53-fold; 95% CI = 1.18-2.01).

Conclusion:

This study showed that even in a country with a universal health care system, there is a strong association between the incidence of pediatric KRT and social deprivation showing that social health inequalities appear from KRT initiation. This study highlights the need to look further into social inequalities in the earliest stage of chronic kidney disease (CKD).
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Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Kidney Int Rep Año: 2024 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Kidney Int Rep Año: 2024 Tipo del documento: Article País de afiliación: Francia