Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1038/s41598-017-05544-1 http://hdl.handle.net/11449/179027 |
Resumo: | The prevalence of patients on automated peritoneal dialysis (APD) is increasing worldwide and may be guided by clinical characteristics, financial issues and patient option. Whether socioeconomic factors at the patient level may influence the decision for the initial peritoneal dialysis (PD) modality is unknown. This is a prospective cohort study. The primary outcome of interest was the probability to start PD on APD. The inclusion criteria were adult patients incident in PD. Exclusion criteria were missing data for either race or initial PD modality. We used a mixed-model analysis clustering patients according to their PD center and region of the country. We included 3,901 patients of which 1,819 (46.6%) had APD as their first modality. We found a significant disparity for race and educational level with African American patients less likely to start on APD (Odds ratio 0.74 CI95% 0.58-0.94) compared to Whites whilst those with greater educational levels were more likely to start on APD (Odds ratio 3.70, CI95% 2.25-6.09) compared to illiterate patients. Limiting the use of APD in disadvantaged population may be unethical. Demographics and socioeconomic status should not be necessarily part of the decision-making process of PD modality choice. |
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Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohortThe prevalence of patients on automated peritoneal dialysis (APD) is increasing worldwide and may be guided by clinical characteristics, financial issues and patient option. Whether socioeconomic factors at the patient level may influence the decision for the initial peritoneal dialysis (PD) modality is unknown. This is a prospective cohort study. The primary outcome of interest was the probability to start PD on APD. The inclusion criteria were adult patients incident in PD. Exclusion criteria were missing data for either race or initial PD modality. We used a mixed-model analysis clustering patients according to their PD center and region of the country. We included 3,901 patients of which 1,819 (46.6%) had APD as their first modality. We found a significant disparity for race and educational level with African American patients less likely to start on APD (Odds ratio 0.74 CI95% 0.58-0.94) compared to Whites whilst those with greater educational levels were more likely to start on APD (Odds ratio 3.70, CI95% 2.25-6.09) compared to illiterate patients. Limiting the use of APD in disadvantaged population may be unethical. Demographics and socioeconomic status should not be necessarily part of the decision-making process of PD modality choice.Pontifícia Universidade Católica Do Paraná (PUCPR)Wessex Renal and Transplant Service Queen Alexandra HospitalPrograma de Pós-Graduação em Medicina e Ciências da Saúde Pontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)Universidade Estadual Paulista (UNESP)Universidade Estadual Paulista (UNESP)Pontifícia Universidade Católica Do Paraná (PUCPR)Queen Alexandra HospitalPontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)Universidade Estadual Paulista (Unesp)Pecoits-Filho, RobertoRibeiro, Silvia CarreiraKirk, AdamDa Silva, Helder SebastiãoPille, ArthurFalavinha, Ricardo SprengerFilho, Sandro ScolariFigueiredo, Ana ElizabethBarretti, Pasqual [UNESP]De Moraes, Thyago Proença2018-12-11T17:33:13Z2018-12-11T17:33:13Z2017-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1038/s41598-017-05544-1Scientific Reports, v. 7, n. 1, 2017.2045-2322http://hdl.handle.net/11449/17902710.1038/s41598-017-05544-12-s2.0-850237451702-s2.0-85023745170.pdf54964119838934790000-0003-4979-4836Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengScientific Reports1,533info:eu-repo/semantics/openAccess2024-01-29T06:30:26Zoai:repositorio.unesp.br:11449/179027Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-01-29T06:30:26Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
title |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
spellingShingle |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort Pecoits-Filho, Roberto |
title_short |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
title_full |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
title_fullStr |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
title_full_unstemmed |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
title_sort |
Racial and social disparities in the access to automated peritoneal dialysis - Results of a national PD cohort |
author |
Pecoits-Filho, Roberto |
author_facet |
Pecoits-Filho, Roberto Ribeiro, Silvia Carreira Kirk, Adam Da Silva, Helder Sebastião Pille, Arthur Falavinha, Ricardo Sprenger Filho, Sandro Scolari Figueiredo, Ana Elizabeth Barretti, Pasqual [UNESP] De Moraes, Thyago Proença |
author_role |
author |
author2 |
Ribeiro, Silvia Carreira Kirk, Adam Da Silva, Helder Sebastião Pille, Arthur Falavinha, Ricardo Sprenger Filho, Sandro Scolari Figueiredo, Ana Elizabeth Barretti, Pasqual [UNESP] De Moraes, Thyago Proença |
author2_role |
author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Pontifícia Universidade Católica Do Paraná (PUCPR) Queen Alexandra Hospital Pontifícia Universidade Católica Do Rio Grande Do sul (PUCRS) Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Pecoits-Filho, Roberto Ribeiro, Silvia Carreira Kirk, Adam Da Silva, Helder Sebastião Pille, Arthur Falavinha, Ricardo Sprenger Filho, Sandro Scolari Figueiredo, Ana Elizabeth Barretti, Pasqual [UNESP] De Moraes, Thyago Proença |
description |
The prevalence of patients on automated peritoneal dialysis (APD) is increasing worldwide and may be guided by clinical characteristics, financial issues and patient option. Whether socioeconomic factors at the patient level may influence the decision for the initial peritoneal dialysis (PD) modality is unknown. This is a prospective cohort study. The primary outcome of interest was the probability to start PD on APD. The inclusion criteria were adult patients incident in PD. Exclusion criteria were missing data for either race or initial PD modality. We used a mixed-model analysis clustering patients according to their PD center and region of the country. We included 3,901 patients of which 1,819 (46.6%) had APD as their first modality. We found a significant disparity for race and educational level with African American patients less likely to start on APD (Odds ratio 0.74 CI95% 0.58-0.94) compared to Whites whilst those with greater educational levels were more likely to start on APD (Odds ratio 3.70, CI95% 2.25-6.09) compared to illiterate patients. Limiting the use of APD in disadvantaged population may be unethical. Demographics and socioeconomic status should not be necessarily part of the decision-making process of PD modality choice. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-12-01 2018-12-11T17:33:13Z 2018-12-11T17:33:13Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1038/s41598-017-05544-1 Scientific Reports, v. 7, n. 1, 2017. 2045-2322 http://hdl.handle.net/11449/179027 10.1038/s41598-017-05544-1 2-s2.0-85023745170 2-s2.0-85023745170.pdf 5496411983893479 0000-0003-4979-4836 |
url |
http://dx.doi.org/10.1038/s41598-017-05544-1 http://hdl.handle.net/11449/179027 |
identifier_str_mv |
Scientific Reports, v. 7, n. 1, 2017. 2045-2322 10.1038/s41598-017-05544-1 2-s2.0-85023745170 2-s2.0-85023745170.pdf 5496411983893479 0000-0003-4979-4836 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Scientific Reports 1,533 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1799965760328564736 |