ArticlePediatric nephrology (Berlin, Germany)2026
Association between estimated time with low glomerular filtration rate and access to transplant among youth with advanced chronic kidney disease.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSlower chronic kidney disease (CKD) progression allows more time for transplant preparation. Whether differences in CKD progression by race/ethnicity associate with preemptive or living donor transplantation in youth has not been well studied.
methodsWe examined the association between time spent with low eGFR (between 10-30 mL/min/1.73 m
resultsAmong 333 youth with CKD (median age 11 years [IQR 7,14]), median time spent with low eGFR was 28.8 months. 77% were preemptively waitlisted, and 45% received preemptive transplantation (56% of White and 24% of Black youth). Black (vs. White) youth had shorter time with low eGFR (-6.5 months; 95% CI -11.5, -1.4). Time with low eGFR did not differ across other groups. Findings were similar using the U25 equation. Every additional year spent with low eGFR was associated with higher odds of preemptive (OR 1.45; 95% CI 1.24-1.70) and living donor transplantation (OR 1.42; 95% CI 1.21-1.67), but not preemptive waitlisting (OR 0.96; 95% CI 0.83-1.11) in unadjusted analyses.
conclusionsLonger time spent with low eGFR is associated with greater odds of preemptive and living donor transplantation. Earlier transplant referral for all children, especially Black youth, may help improve access to preemptive and living donor transplantation.
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