Racial and social disparities in the access to automated peritoneal dialysis - results of a national PD cohort
Abstract 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...
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Nature Portfolio
2017
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oai:doaj.org-article:ab59d7283af64f29b2429cd8d35e7fd72021-12-02T16:06:06ZRacial and social disparities in the access to automated peritoneal dialysis - results of a national PD cohort10.1038/s41598-017-05544-12045-2322https://doaj.org/article/ab59d7283af64f29b2429cd8d35e7fd72017-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-05544-1https://doaj.org/toc/2045-2322Abstract 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.Roberto Pecoits-FilhoSilvia Carreira RibeiroAdam KirkHelder Sebastião da SilvaArthur PilleRicardo Sprenger FalavinhaSandro Scolari FilhoAna Elizabeth FigueiredoPasqual BarrettiThyago Proença de MoraesNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-7 (2017) |
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Medicine R Science Q |
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Medicine R Science Q Roberto Pecoits-Filho Silvia Carreira Ribeiro Adam Kirk Helder Sebastião da Silva Arthur Pille Ricardo Sprenger Falavinha Sandro Scolari Filho Ana Elizabeth Figueiredo Pasqual Barretti Thyago Proença de Moraes Racial and social disparities in the access to automated peritoneal dialysis - results of a national PD cohort |
| description |
Abstract 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. |
| format |
article |
| author |
Roberto Pecoits-Filho Silvia Carreira Ribeiro Adam Kirk Helder Sebastião da Silva Arthur Pille Ricardo Sprenger Falavinha Sandro Scolari Filho Ana Elizabeth Figueiredo Pasqual Barretti Thyago Proença de Moraes |
| author_facet |
Roberto Pecoits-Filho Silvia Carreira Ribeiro Adam Kirk Helder Sebastião da Silva Arthur Pille Ricardo Sprenger Falavinha Sandro Scolari Filho Ana Elizabeth Figueiredo Pasqual Barretti Thyago Proença de Moraes |
| author_sort |
Roberto Pecoits-Filho |
| title |
Racial and social disparities in the access to automated peritoneal dialysis - results of a national PD cohort |
| 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 |
| publisher |
Nature Portfolio |
| publishDate |
2017 |
| url |
https://doaj.org/article/ab59d7283af64f29b2429cd8d35e7fd7 |
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