Evidence map›Paper›PMID 26692022›Full record

ArticlePediatric nephrology (Berlin, Germany)2016

The impact of socioeconomic status and geographic remoteness on access to pre-emptive kidney transplantation and transplant outcomes among children.

Anna Francis, Madeleine Didsbury, Wai H Lim, Siah Kim, Sarah White, Jonathan C Craig, Germaine Wong

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Implementing Patient Navigation for Children With CKD.Kidney international reports · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. The impact of rural status on pediatric chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2024
    Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. NAVKIDSTrials · 2022
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anna FrancisSydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006.
Madeleine DidsburySydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006.
Wai H LimSir Charles Gairdner Hospital, Nedlands, WA, Australia.
Siah KimSydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006.
Sarah WhiteSydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006.
Jonathan C CraigSydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006.
Germaine WongSydney School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006. germaine.wong@health.nsw.gov.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow socioeconomic status (SES) and geographic disparity have been associated with worse outcomes and poorer access to pre-emptive transplantation in the adult end-stage kidney disease (ESKD) population, but little is known about their impact in children with ESKD. The aim of our study was to determine whether access to pre-emptive transplantation and transplant outcomes differ according to SES and geographic remoteness in Australia.

methodsUsing data from the Australia and New Zealand Dialysis and Transplant Registry (1993-2012), we compared access to pre-emptive transplantation, the risk of acute rejection and graft failure, based on SES and geographic remoteness among Australian children with ESKD (≤ 18 years), using adjusted logistic and Cox proportional hazard modelling.

resultsOf the 768 children who commenced renal replacement therapy, 389 (50.5%) received living donor kidney transplants and 28.5% of these (111/389) were pre-emptive. There was no significant association between SES quintiles and access to pre-emptive transplantation, acute rejection or allograft failure. Children residing in regional or remote areas were 35% less likely to receive a pre-emptive transplant compared to those living in major cities [adjusted odds ratio (OR) 0.65, 95% confidence interval (CI) 0.45-1.0]. There was no significant association between geographic disparity and acute rejection (adjusted OR 1.03, 95% CI 0.68-1.57) or graft loss (adjusted hazard ratio 1.05, 95% CI 0.74-1.41).

conclusionsIn Australia, children from regional or remote regions are much less likely to receive pre-emptive kidney transplantation. Strategies such as improved access to nephrology services through expanding the scope of outreach clinics, and support for regional paediatricians to promote early referral may ameliorate this inequity.

Indexed as

Health Services AccessibilityRural Health ServicesSocial ClassAdolescentAustraliaChildChild, PreschoolFemaleGraft RejectionHealthcare DisparitiesHumansInfantInfant, NewbornKidney Failure, ChronicKidney TransplantationLiving DonorsGeographic remotenessKidney transplantationPaediatricsPre-emptive living donor transplantationSocioeconomic factorsSurvival analyses

Identifiers

PMID26692022

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.