Are There Inequities in Treatment of End-Stage Renal Disease in Sweden? A Longitudinal Register-Based Study on Socioeconomic Status-Related Access to Kidney Transplantation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Material
2.2. Study Population
3. Results
3.1. Baseline Characteristics
3.2. Effects of SES on Access to Kidney Transplantation
3.3. Sensitive Analyses
4. Discussion
Strengths and Limitations
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics | Entire Study Population (n = 16,215) | Dialysis (n = 11,823) | Kidney Transplantation (n = 4392) | Pre-Emptive Tx (n = 612) # | Living-Donor Tx (n = 1754) | Deceased-Do nor Tx (n = 2645) |
---|---|---|---|---|---|---|
Age (years) *** | ||||||
18–39 | 8.9 | 2.3 | 26.7 | 35.4 | 38.3 | 19.0 |
40–49 | 10.1 | 4.8 | 24.2 | 23.1 | 24.2 | 24.2 |
50–59 | 16.5 | 11.5 | 29.8 | 25.5 | 24.2 | 33.5 |
60+ | 64.6 | 81.4 | 19.4 | 16.0 | 13.3 | 23.4 |
Male | 65.4 | 65.5 | 65.1 | 62.5 | 66.7 | 64.0 |
Year of first RRT *** | 2004 (5.1) | 2004 (5.2) | 2003 (4.9) | 2005 (5.3) | 2004 (5.0) | 2003 (4.8) |
Education *** | ||||||
mandatory | 46.2 | 54.1 | 25.1 | 15.4 | 19.7 | 28.6 |
high school | 38.5 | 34.9 | 48.0 | 48.5 | 49.1 | 47.3 |
college | 15.3 | 11.0 | 26.9 | 36.2 | 31.2 | 24.0 |
Marital status *** | ||||||
married | 52.3 | 52.8 | 51.0 | 55.8 | 53.8 | 49.2 |
single | 20.5 | 15.7 | 33.3 | 34.4 | 35.7 | 31.7 |
divorced | 15.1 | 15.6 | 13.6 | 8.4 | 9.6 | 16.3 |
widow | 12.1 | 15.9 | 2.1 | 1.5 | 0.9 | 2.8 |
Disposable income *** | ||||||
quintile 1 (0–99,998 SEK) | 20.0 | 21.0 | 17.3 | 12.1 | 16.7 | 17.6 |
quintile 2 (100,002–122,743 SEK) | 20.0 | 21.7 | 15.4 | 13.1 | 14.2 | 16.2 |
quintile 3 (122,755–146,224 SEK) | 20.0 | 21.7 | 15.5 | 15.4 | 14.6 | 16.1 |
quintile 4 (146,231–188,732 SEK) | 20.0 | 19.1 | 22.5 | 20.1 | 23.5 | 21.9 |
quintile 5 (188,751–6,685,735 SEK) | 20.0 | 16.5 | 29.3 | 39.3 | 30.9 | 28.2 |
Swedish ** | 86.8 | 86.3 | 88.2 | 90.5 | 90.2 | 86.9 |
missing | 9.6 | 10.5 | 7.4 | 6.1 | 5.6 | 8.5 |
Tx centers *** | 48.8 | 47.9 | 51.1 | 57.1 | 51.9 | 50.6 |
Primary renal disease *** | ||||||
APKD | 7.0 | 4.1 | 14.7 | 15.1 | 13.4 | 15.5 |
diabetic nephropathy | 25.6 | 28.3 | 18.5 | 15.1 | 15.9 | 20.2 |
glomerulonephritis | 15.3 | 10.0 | 29.5 | 31.2 | 34.4 | 26.2 |
hypertension | 12.1 | 14.5 | 5.6 | 3.6 | 4.8 | 6.1 |
pyelonephritis | 3.5 | 3.6 | 3.4 | 2.5 | 2.4 | 4.1 |
unspecified kidney disease | 12.0 | 13.3 | 8.3 | 12.3 | 8.4 | 8.3 |
others | 24.5 | 26.2 | 20.1 | 20.3 | 20.8 | 19.6 |
Comorbidities *** | ||||||
hypertension | 70.4 | 71.0 | 68.8 | 67.3 | 68.8 | 68.7 |
diabetes mellitus | 31.3 | 36.0 | 18.6 | 16.0 | 15.7 | 20.5 |
heart disease | 35.0 | 43.8 | 11.2 | 6.6 | 9.0 | 12.6 |
cancer | 12.6 | 16.2 | 3.0 | 2.5 | 2.9 | 3.0 |
Variables Included in Model | Model 1 Crude OR of Income (95% CI) | Model 2 Adjusted for Education OR (95% CI) | Model 3 Adjusted for Model 2 + Demo. OR (95% CI) | Model 4 Adjusted for Model 3 + Clinical OR (95% CI) |
---|---|---|---|---|
Disposable income (ref = quintile 1) | ||||
quintile 2 (100,002–122,743 SEK) | 0.86 * (0.77–0.97) | 0.80 *** (0.71–0.90) | 1.02 (0.88–1.19) | 1.12 (0.95–1.33) |
quintile 3 (122,755–146,224 SEK) | 0.87 * (0.78–0.98) | 0.77 *** (0.68–0.87) | 1.10 (0.94–1.28) | 1.21 * (1.03–1.43) |
quintile 4 (146,231–188,732 SEK) | 1.44 *** (1.29–1.61) | 1.10 (0.98–1.24) | 1.79 *** (1.54–2.08) | 1.91 *** (1.63–2.24) |
quintile 5 (188,751–6,685,735 SEK) | 2.16 *** (1.94–2.40) | 1.40 *** (1.25–1.56) | 3.23 *** (2.77–3.76) | 3.22 *** (2.73–3.80) |
Education (ref = mandatory) | ||||
high school | 2.80 *** (2.58–3.05) | 1.46 *** (1.32–1.62) | 1.48 *** (1.32–1.65) | |
college | 4.56 *** (4.11–5.07) | 2.47 *** (2.16–2.82) | 2.35 *** (2.03–2.72) | |
Age at referral (years) (ref = 18 to 39) | ||||
40 to 49 | 0.36 *** (0.30–0.43) | 0.36 *** (0.30–0.44) | ||
50 to 59 | 0.15 *** (0.13–0.18) | 0.17 *** (0.14–0.21) | ||
60+ | 0.02 *** (0.01–0.02) | 0.02 *** (0.02–0.03) | ||
Sex (ref = female) | ||||
male | 0.91 (0.83–1.01) | 0.99 (0.89–1.10) | ||
Year of first RRT | 0.94 *** (0.93–0.95) | 0.94 *** (0.93–0.95) | ||
Marital status (ref = married) | ||||
single | 0.59 *** (0.52–0.66) | 0.57 *** (0.50–0.66) | ||
divorced | 0.63 *** (0.55–0.72) | 0.65 *** (0.56–0.75) | ||
widow | 0.31 *** (0.24–0.39) | 0.29 *** (0.23–0.37) | ||
Citizenship (ref = non-Swedish) | ||||
Swedish | 1.36 ** (1.08–1.72) | 1.43 ** (1.11–1.84) | ||
missing | 0.58 *** (0.44–0.78) | 0.59 ** (0.43–0.80) | ||
Home county (ref = non Tx centers) | ||||
Tx centers | 0.94 (0.86–1.03) | 0.92 (0.83–1.01) | ||
Primary renal disease (ref = APKD) | ||||
diabetic nephropathy | 0.26 *** (0.21–0.33) | |||
glomerulonephritis | 0.76 ** (0.62–0.92) | |||
hypertension | 0.29 *** (0.23–0.37) | |||
pyelonephritis | 0.52 *** (0.38–0.69) | |||
unspecified kidney disease | 0.29 *** (0.23–0.36) | |||
others | 0.32 *** (0.27–0.39) | |||
Comorbidities (ref = non comorbidities) | ||||
hypertension | 1.74 *** (1.52–1.99) | |||
diabetes mellitus | 0.57 *** (0.48–0.67) | |||
heart disease | 0.29 *** (0.26–0.33) | |||
cancer | 0.23 *** (0.18–0.28) |
Variables Included in Model | Model 1 Crude OR of Education (95% CI) | Model 2 Adjusted for Demo. OR (95% CI) | Model 3 Adjusted for Model 2 + Clinical OR (95% CI) |
---|---|---|---|
Education (ref = mandatory) | |||
high school | 2.97 *** (2.73–3.23) | 1.67 *** (1.51–1.85) | 1.68 *** (1.51–1.88) |
college | 5.25 *** (4.74–5.81) | 3.36 *** (2.96–3.82) | 3.18 *** (2.77–3.66) |
Age at referral (years) (ref = 18 to 39) | |||
40 to 49 | 0.39 *** (0.33–0.46) | 0.40 *** (0.33–0.48) | |
50 to 59 | 0.19 *** (0.16–0.22) | 0.21 *** (0.18–0.26) | |
60+ | 0.02 *** (0.01–0.02) | 0.02 *** (0.02–0.03) | |
Sex (ref = female) | |||
male | 1.06 (0.96–1.16) | 1.14 * (1.03–1.26) | |
Year of first RRT | 0.96 *** (0.95–0.97) | 0.96 *** (0.95–0.97) | |
Marital status (ref = married) | |||
single | 0.57 *** (0.51–0.65) | 0.56 *** (0.50–0.64) | |
divorced | 0.63 *** (0.55–0.72) | 0.65 *** (0.57–0.75) | |
widow | 0.34 *** (0.27–0.43) | 0.32 *** (0.25–0.41) | |
Citizenship (ref = non-Swedish) | |||
Swedish | 1.64 *** (1.31–2.06) | 1.73 *** (1.35–2.22) | |
missing | 0.74 * (0.56–0.98) | 0.72 * (0.53–0.98) | |
Home county (ref = non Tx centers) | |||
Tx centers | 0.99 (0.91–1.08) | 0.96 (0.87–1.06) | |
Primary renal disease (ref = APKD) | |||
diabetic nephropathy | 0.27 *** (0.21–0.34) | ||
glomerulonephritis | 0.77 ** (0.64–0.94) | ||
hypertension | 0.28 *** (0.22–0.35) | ||
pyelonephritis | 0.50 *** (0.38–0.67) | ||
unspecified kidney disease | 0.28 *** (0.23–0.35) | ||
others | 0.32 *** (0.27–0.38) | ||
Comorbidities (ref = non comorbidities) | |||
hypertension | 1.73 *** (1.52–1.97) | ||
diabetes mellitus | 0.54 *** (0.46–0.64) | ||
heart disease | 0.29 *** (0.26–0.33) | ||
cancer | 0.23 *** (0.19–0.29) |
Variables Included in Model | Model 1 for Pre-Emptive Transplantation Sample (n = 12,624) | Model 2 for Later Kidney Transplantation Sample (n = 15,414) | Model 3 for Working Aged Patients Sample (n = 6844) | Model 4 for Working Aged Patients Sample + Employment Status (n = 6844) |
---|---|---|---|---|
Disposable income (ref = quintile 1) | ||||
quintile 2 (100,002–122,743 SEK) | 1.19 (0.84–1.69) | 1.11 (0.94–1.32) | 1.09 (0.90–1.33) | 1.04 (0.85–1.27) |
quintile 3 (122,755–146,224 SEK) | 1.63 ** (1.16–2.28) | 1.15 (0.97–1.37) | 1.07 (0.88–1.30) | 0.96 (0.79–1.17) |
quintile 4 (146,231–188,732 SEK) | 2.32 *** (1.67–3.22) | 1.86 *** (1.57–2.20) | 1.64 *** (1.35–1.98) | 1.30 ** (1.06–1.58) |
quintile 5 (188,751–6,685,735 SEK) | 4.00 *** (2.89–5.53) | 3.06 *** (2.58–3.64) | 2.50 *** (2.05–3.05) | 1.69 *** (1.37–2.08) |
Education (ref = mandatory) | ||||
high school | 1.94 *** (1.53–2.48) | 1.44 *** (1.28–1.62) | 1.39 *** (1.22–1.59) | 1.32 *** (1.15–1.51) |
college | 3.50 *** (2.64–4.64) | 2.23 *** (1.92–2.60) | 2.32 *** (1.94–2.77) | 2.00 *** (1.66–2.39) |
Age at referral (years) (ref = 18 to 39) | ||||
40 to 49 | 0.22 *** (0.16–0.30) | 0.38 *** (0.31–0.47) | 0.40 *** (0.33–0.49) | 0.38 *** (0.31–0.47) |
50 to 59 | 0.09 *** (0.07–0.13) | 0.19 *** (0.15–0.23) | 0.18 *** (0.15–0.22) | 0.19 *** (0.16–0.23) |
60 + | 0.01 *** (0.01–0.02) | 0.02 *** (0.02–0.03) | 0.08 *** (0.07–0.10) | 0.10 *** (0.08–0.13) |
Sex (ref = female) | ||||
male | 0.88 (0.72–1.08) | 1.03 (0.92–1.16) | 1.07 (0.94–1.21) | 1.05 (0.92–1.19) |
Year of first RRT | 1.02 (1.00–1.04) | 0.92 *** (0.91–0.93) | 0.92 *** (0.91–0.93) | 0.92 *** (0.90–0.93) |
Marital status (ref = married) | ||||
single | 0.38 *** (0.30–0.49) | 0.62 *** (0.54–0.71) | 0.49 *** (0.43–0.57) | 0.53 *** (0.45–0.61) |
divorced | 0.33 *** (0.24–0.46) | 0.70 *** (0.60–0.81) | 0.52 *** (0.44–0.61) | 0.56 *** (0.48–0.66) |
widow | 0.21 *** (0.11–0.40) | 0.31 *** (0.24–0.40) | 0.43 *** (0.29–0.64) | 0.50 *** (0.33–0.74) |
Citizenship (ref = non-Swedish) | ||||
Swedish | 2.46 ** (1.47–4.11) | 1.41 ** (1.09–1.83) | 1.60 *** (1.23–2.10) | 1.41 * (1.08–1.85) |
missing | 1.22 (0.65–2.30) | 0.54 *** (0.40–0.75) | 0.77 (0.55–1.10) | 0.60 ** (0.42–0.85) |
Home county (ref = non Tx centers) | ||||
Tx centers | 1.22 * (1.008–1.48) | 0.88 * (0.80–0.98) | 0.95 (0.84–1.07) | 0.94 (0.84–1.06) |
Primary renal disease (ref = APKD) | ||||
diabetic nephropathy | 0.25 *** (0.17–0.38) | 0.26 *** (0.21–0.33) | 0.27 *** (0.21–0.35) | 0.28 *** (0.21–0.37) |
glomerulonephritis | 0.68 * (0.49–0.94) | 0.78 * (0.63–0.95) | 0.78 * (0.62–0.99) | 0.77 * (0.60–0.98) |
hypertension | 0.21 *** (0.12–0.34) | 0.31 *** (0.24–0.39) | 0.40 *** (0.30–0.55) | 0.43 *** (0.31–0.58) |
pyelonephritis | 0.39 ** (0.22–0.72) | 0.55 *** (0.41–0.75) | 0.79 (0.53–1.17) | 0.78 (0.53–1.16) |
unspecified kidney disease | 0.32 *** (0.22–0.46) | 0.28 *** (0.22–0.35) | 0.37 *** (0.28–0.49) | 0.39 *** (0.29–0.51) |
others | 0.28 *** (0.20–0.39) | 0.34 *** (0.28–0.41) | 0.38 *** (0.31–0.48) | 0.40 *** (0.32–0.50) |
Comorbidities (ref = non comorbidities) | ||||
hypertension | 1.16 (0.91–1.47) | 1.89 *** (1.64–2.17) | 1.70 *** (1.45–1.99) | 1.63 *** (1.39–1.92) |
diabetes mellitus | 0.49 *** (0.35–0.69) | 0.58 *** (0.49–0.70) | 0.60 *** (0.49–0.74) | 0.66 *** (0.54–0.81) |
heart disease | 0.20 *** (0.15–0.28) | 0.31 *** (0.27–0.36) | 0.35 *** (0.30–0.41) | 0.38 *** (0.32–0.44) |
cancer | 0.14 *** (0.08–0.24) | 0.24 *** (0.19–0.30) | 0.25 *** (0.19–0.33) | 0.25 *** (0.19–0.34) |
Employment (ref = non-employment) | ||||
employment | 2.55 *** (2.23–2.92) |
Variables Included in Model | Model 1 for Pre-Emptive Transplantation Sample (n = 12,624) | Model 2 for Later Kidney Transplantation Sample (n = 15,414) | Model 3 for Working Aged Patients Sample (n = 6844) | Model 4 for Working Aged Patients Sample + Employment Status (n = 6844) |
---|---|---|---|---|
Education (ref = mandatory) | ||||
high school | 2.27 *** (1.79–2.87) | 1.64 *** (1.46–1.84) | 1.51 *** (1.33–1.72) | 1.36 *** (1.19–1.56) |
college | 4.89 *** (3.73–6.41) | 3.01 *** (2.60–3.49) | 2.87 *** (2.41–3.41) | 2.19 *** (1.83–2.62) |
Age at referral (years) (ref = 18 to 39) | ||||
40 to 49 | 0.25 *** (0.18–0.33) | 0.42 *** (0.35–0.51) | 0.43 *** (0.35–0.52) | 0.39 *** (0.32–0.48) |
50 to 59 | 0.13 *** (0.09–0.17) | 0.23 *** (0.19–0.28) | 0.21 *** (0.17–0.26) | 0.21 *** (0.17–0.25) |
60+ | 0.01 *** (0.01–0.02) | 0.03 *** (0.02–0.03) | 0.10 *** (0.08–0.12) | 0.12 *** (0.09–0.14) |
Sex (ref = female) | ||||
male | 1.06 (0.87–1.29) | 1.17 ** (1.05–1.31) | 1.19 ** (1.05–1.35) | 1.11 (0.98–1.26) |
Year of first RRT | 1.04 ** (1.02–1.06) | 0.94 *** (0.93–0.95) | 0.93 *** (0.92–0.95) | 0.92 *** (0.91–0.94) |
Marital status (ref = married) | ||||
single | 0.38 *** (0.30–0.49) | 0.61 *** (0.53–0.70) | 0.49 *** (0.42–0.56) | 0.52 *** (0.45–0.61) |
divorced | 0.33 *** (0.24–0.46) | 0.71 *** (0.61–0.82) | 0.51 *** (0.44–0.60) | 0.57 *** (0.48–0.67) |
widow | 0.23 *** (0.12–0.45) | 0.34 *** (0.26–0.44) | 0.51 *** (0.34–0.75) | 0.55 *** (0.37–0.82) |
Citizenship (ref = non-Swedish) | ||||
Swedish | 3.40 *** (2.04–5.65) | 1.68 *** (1.30–2.17) | 1.88 *** (1.45–2.45) | 1.51 ** (1.16–1.97) |
missing | 1.66 (0.89–3.12) | 0.67 * (0.49–0.91) | 0.92 (0.65–1.29) | 0.63 ** (0.44–0.90) |
Home county (ref = non Tx centers) | ||||
Tx centers | 1.31 ** (1.09–1.58) | 0.92 (0.83–1.02) | 0.98 (0.87–1.10) | 0.96 (0.85–1.08) |
Primary renal disease (ref = APKD) | ||||
diabetic nephropathy | 0.27 *** (0.18–0.40) | 0.27 *** (0.21–0.34) | 0.27 *** (0.21–0.36) | 0.28 *** (0.21–0.37) |
glomerulonephritis | 0.73 (0.53–1.00) | 0.79 * (0.65–0.97) | 0.79 * (0.62–0.99) | 0.77 * (0.61–0.98) |
hypertension | 0.20 *** (0.12–0.33) | 0.30 *** (0.23–0.37) | 0.38 *** (0.28–0.51) | 0.41 *** (0.30–0.56) |
pyelonephritis | 0.39 ** (0.22–0.72) | 0.54 *** (0.40–0.73) | 0.77 (0.52–1.14) | 0.78 (0.52–1.15) |
unspecified kidney disease | 0.33 *** (0.22–0.47) | 0.27 *** (0.21–0.34) | 0.36 *** (0.28–0.47) | 0.38 *** (0.29–0.51) |
others | 0.29 *** (0.21–0.40) | 0.34 *** (0.28–0.41) | 0.38 *** (0.30–0.48) | 0.40 *** (0.32–0.50) |
Comorbidities (ref= non comorbidities) | ||||
hypertension | 1.13 (0.89–1.43) | 1.88 *** (1.64–2.16) | 1.70 *** (1.45–1.99) | 1.62 *** (1.38–1.91) |
diabetes mellitus | 0.46 *** (0.33–0.64) | 0.56 *** (0.47–0.67) | 0.58 *** (0.48–0.71) | 0.66 *** (0.54–0.81) |
heart disease | 0.21 *** (0.15–0.28) | 0.31 *** (0.27–0.36) | 0.35 *** (0.30–0.41) | 0.38 *** (0.32–0.44) |
cancer | 0.15 *** (0.09–0.25) | 0.25 *** (0.20–0.31) | 0.25 *** (0.19–0.33) | 0.26 *** (0.19–0.34) |
Employment (ref = non-employment) | ||||
employment | 2.90 *** (2.55–3.29) |
Variables Included in Model | Model 1 Crude HR of Income (95% CI) | Model 2 Adjusted for Education HR (95% CI) | Model 3 Adjusted for Model 2 + Demo. HR (95% CI) | Model 4 ADJUSTED for Model 3 + Clinical HR (95% CI) |
---|---|---|---|---|
Disposable income (ref = quintile 1) | ||||
quintile 2 (100,002–122,743 SEK) | 0.88 * (0.78–0.98) | 0.84 ** (0.75–0.94) | 1.03 (0.92–1.16) | 1.08 (0.96–1.21) |
quintile 3 (122,755–146,224 SEK) | 0.85** (0.76–0.96) | 0.78 *** (0.70–0.88) | 1.00 (0.89–1.12) | 1.07 (0.95–1.20) |
quintile 4 (146,231–188,732 SEK) | 1.33 *** (1.20–1.47) | 1.08 (0.97–1.20) | 1.47 *** (1.32–1.63) | 1.50 *** (1.35–1.67) |
quintile 5 (188,751–6,685,735 SEK) | 1.73 *** (1.56–1.91) | 1.23 *** (1.11–1.36) | 1.98 *** (1.78–2.20) | 1.93 *** (1.73–2.15) |
Education (ref = mandatory) | ||||
high school | 2.18 *** (2.02–2.37) | 1.26 *** (1.16–1.37) | 1.23 *** (1.14–1.34) | |
college | 3.10 *** (2.82–3.41) | 1.85 *** (1.68–2.03) | 1.71 *** (1.55–1.88) | |
Age at referral (years) (ref = 18 to 39) | ||||
40 to 49 | 0.60 *** (0.55–0.66) | 0.62 *** (0.56–0.68) | ||
50 to 59 | 0.36 *** (0.33–0.40) | 0.40 *** (0.36–0.44) | ||
60+ | 0.07 *** (0.06–0.08) | 0.09 *** (0.08–0.10) | ||
Sex (ref = female) | ||||
male | 1.03 (0.96–1.11) | 1.05 (0.98–1.13) | ||
Year of first RRT | 0.98 *** (0.97–0.98) | 0.99 *** (0.98–0.99) | ||
Marital status (ref = married) | ||||
single | 0.79 *** (0.73–0.86) | 0.80 *** (0.74–0.87) | ||
divorced | 0.78 *** (0.71–0.86) | 0.80 *** (0.73–0.88) | ||
widow | 0.39 *** (0.31–0.49) | 0.39 *** (0.31–0.49) | ||
Citizenship (ref = non-Swedish) | ||||
Swedish | 1.33 *** (1.14–1.57) | 1.44 *** (1.22–1.69) | ||
missing | 1.18 (0.96–1.44) | 1.25 * (1.01–1.53) | ||
Home county (ref = non Tx centers) | ||||
Tx centers | 0.93 * (0.87–0.99) | 0.91 ** (0.86–0.98) | ||
Primary renal disease (ref = APKD) | ||||
diabetic nephropathy | 0.56 *** (0.48–0.65) | |||
glomerulonephritis | 0.87 * (0.78–0.97) | |||
hypertension | 0.52 *** (0.44–0.61) | |||
pyelonephritis | 0.70 *** (0.57–0.85) | |||
unspecified kidney disease | 0.52 *** (0.45–0.61) | |||
others | 0.57 *** (0.51–0.64) | |||
Comorbidities (ref = non comorbidities) | ||||
hypertension | 1.25 *** (1.15–1.36) | |||
diabetes mellitus | 0.66 *** (0.58–0.75) | |||
heart disease | 0.46 *** (0.41–0.51) | |||
cancer | 0.42 *** (0.35–0.51) |
Variables Included in Model | Model 1 Crude HR of Education (95% CI) | Model 2 Adjusted for Demo. HR (95% CI) | Model 3 Adjusted for Model 2 + Clinical HR (95% CI) |
---|---|---|---|
Education (ref = mandatory) | |||
high school | 2.28 *** (2.11–2.47) | 1.39 *** (1.28–1.51) | 1.36 *** (1.25–1.47) |
college | 3.46 *** (3.16–3.78) | 2.22 *** (2.02–2.44) | 2.02 *** (1.84–2.22) |
Age at referral (years) (ref = 18 to 39) | |||
40 to 49 | 0.64 *** (0.58–0.70) | 0.65 *** (0.59–0.71) | |
50 to 59 | 0.41 *** (0.37–0.45) | 0.45 *** (0.41–0.50) | |
60+ | 0.08 *** (0.07–0.09) | 0.10 *** (0.09–0.12) | |
Sex (ref = female) | |||
male | 1.12 ** (1.04–1.20) | 1.13 ** (1.05–1.21) | |
Year of first RRT | 0.99 *** (0.98–0.99) | 0.99 (0.99–1.00) | |
Marital status (ref = married) | |||
single | 0.80 *** (0.73–0.86) | 0.81 *** (0.75–0.88) | |
divorced | 0.78 *** (0.71–0.86) | 0.81 *** (0.73–0.89) | |
widow | 0.41 *** (0.33–0.52) | 0.41 *** (0.33–0.52) | |
Citizenship (ref = non-Swedish) | |||
Swedish | 1.52 *** (1.30–1.78) | 1.63 *** (1.39–1.91) | |
missing | 1.35 ** (1.10–1.65) | 1.42 ** (1.15–1.74) | |
Home county (ref = non Tx centers) | |||
Tx centers | 0.95 (0.89–1.02) | 0.94 (0.88–1.00) | |
Primary renal disease (ref = APKD) | |||
diabetic nephropathy | 0.56 *** (0.48–0.65) | ||
glomerulonephritis | 0.89 * (0.80–0.99) | ||
hypertension | 0.51 *** (0.44–0.60) | ||
pyelonephritis | 0.70 *** (0.57–0.85) | ||
unspecified kidney disease | 0.51 *** (0.44–0.60) | ||
others | 0.57 *** (0.51–0.64) | ||
Comorbidities (ref = non comorbidities) | |||
hypertension | 1.25 *** (1.14–1.36) | ||
diabetes mellitus | 0.65 *** (0.57–0.74) | ||
heart disease | 0.45 *** (0.41–0.51) | ||
cancer | 0.42 *** (0.35–0.51) |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).
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Zhang, Y.; Jarl, J.; Gerdtham, U.-G. Are There Inequities in Treatment of End-Stage Renal Disease in Sweden? A Longitudinal Register-Based Study on Socioeconomic Status-Related Access to Kidney Transplantation. Int. J. Environ. Res. Public Health 2017, 14, 119. https://doi.org/10.3390/ijerph14020119
Zhang Y, Jarl J, Gerdtham U-G. Are There Inequities in Treatment of End-Stage Renal Disease in Sweden? A Longitudinal Register-Based Study on Socioeconomic Status-Related Access to Kidney Transplantation. International Journal of Environmental Research and Public Health. 2017; 14(2):119. https://doi.org/10.3390/ijerph14020119
Chicago/Turabian StyleZhang, Ye, Johan Jarl, and Ulf-G. Gerdtham. 2017. "Are There Inequities in Treatment of End-Stage Renal Disease in Sweden? A Longitudinal Register-Based Study on Socioeconomic Status-Related Access to Kidney Transplantation" International Journal of Environmental Research and Public Health 14, no. 2: 119. https://doi.org/10.3390/ijerph14020119