Evidence map›Paper›PMID 33675411›Full record

ArticlePediatric nephrology (Berlin, Germany)2021

Access to treatment for chronic kidney disease by children and adolescents in Brazil.

Isabel de Pádua Paz, Tulio Konstantyner, Ricardo de Castro Cintra Sesso, Cristine Campos de Xavier Pinto, Maria Fernanda Carvalho de Camargo, Paulo Cesar Koch Nogueira

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Article in Pediatric nephrology (Berlin, Germany), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

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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

6 authors.

Isabel de Pádua PazDepartment of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil. isabelppaz@gmail.com.ORCID 0000-0003-4900-4494
Tulio KonstantynerDepartment of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.
Ricardo de Castro Cintra SessoNephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
Cristine Campos de Xavier PintoEscola de Economia de São Paulo, Fundação Getúlio Vargas, Sao Paulo, Brazil.
Maria Fernanda Carvalho de CamargoHospital Samaritano de São Paulo, Sao Paulo, Brazil.
Paulo Cesar Koch NogueiraDepartment of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to identify main factors associated with child and adolescent access to chronic kidney disease (CKD) treatment in Brazil.

methodsMulti-center cross-sectional study conducted in eight pediatric nephrology centers across all Brazilian geographic regions. Information was collected on characteristics associated with referral and treatment of patients with CKD. The following outcomes were analyzed as follows: (1) age at first consultation, and (2) time elapsed between referral and treatment at the specialized service.

resultsThree hundred thirty-five children were assessed. Variables associated with age at first consultation were as follows: CAKUT (HR=1.7; 95%CI 1.3-2.2, p<0.01); private health plan (HR=1.54; 95%CI 1.06-2.23, p=0.02); modified Medical Outcomes Study Social Support Survey mMOS-SS score (HR=1.02; 95%CI 1.00-1.03, p=0.024); maternal age (HR=0.96; 95%CI 0.95-0.97, p<0.01); and number of siblings in the household (HR=0.86; 95%CI 0.79-0.83, p<0.01). Significant variables associated with time elapsed between referral and treatment at the specialized service were as follows: each additional occupant sharing the household (HR=0.94; 95%CI:0.89-0.99, p=0.02), residing in the Northeast (HR=0.81; 95%CI:0.67-0.98, p=0.03) and having someone to take them to the physician (HR=1.36; 95%CI 1.07-1.74, p=0.01). The median time interval between patient referral and treatment by the service was 11 days (IQR 10-31).

conclusionThere are potentially modifiable factors hampering access of children with CKD to specialized treatment. The importance of the role of social support for the two outcomes should serve as an alert for health managers and professionals to consider this aspect throughout all steps of the care process of children with CKD.

Indexed as

Renal Insufficiency, ChronicAdolescentBrazilCross-Sectional StudiesHealth Services AccessibilityHumansNephrologyChildrenChronic kidney diseaseSocial health support, Kidney failure

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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.