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BACKGROUND: Social deprivation is associated with increased mortality for patients on renal replacement therapy. Patients from lower socioeconomic categories have reduced access to transplantation. However, the impact of social deprivation on outcomes following renal transplantation is unknown. METHODOLOGY: We undertook a retrospective analysis of all patients undergoing renal transplantation at a single center serving the West of Scotland over the 10-year period 2000 to 2010 (n = 705). Postcode data permitted calculation of a Scottish Index of Multiple Deprivation (SIMD) score, which was analyzed in quartiles from 0% to 25% (least deprived) to 75% to 100% (most deprived). Outcomes measures were graft loss, mortality, creatinine at 1 year, delayed graft function (DGF), and biopsy-proven acute rejection (BPAR). Kaplan-Meier survival analysis was undertaken (P < .05 is significant). Results are presented as percentages of the total population in SIMD quartiles 0% to 25%, 25% to 50%, 50% to 70%, and 75% to 100%, respectively. RESULTS: Mean follow-up was 5.86 ± 0.11 years. There was no difference in survival following renal transplantation depending on SIMD (89.6%, 87%, 88.4%, 90.2%; P = .82). There was improved graft survival in the least socioeconomically deprived; however, this was not significant (80%, 69.9%, 74.1%, 73.8%; P = .34). Similarly, there was a nonsignificant trend toward lower creatinine at 1 year in the least deprived patients (163.5 ± 12.8, 211.7 ± 19.5, 170.2 ± 9.8, 197.1 ± 6.9; P = .07). There was no difference in rates of DGF (P = .47), primary nonfunction (P = .17), or BPAR (P = .97) depending on socioeconomic status. The proportion of patients undergoing living donor transplantation was similar across the range of SIMD (23.9%, 27.6%, 25.5%, 21.8%; P = .76). CONCLUSIONS: Social deprivation does not affect either graft or patient survival after renal transplantation. Additionally, it did not influence the rate of living donor renal transplantation in our patient population.

Original publication

DOI

10.1016/j.transproceed.2012.12.031

Type

Journal article

Journal

Transplant Proc

Publication Date

07/2013

Volume

45

Pages

2176 - 2183

Keywords

Acute Disease, Adolescent, Adult, Aged, Biomarkers, Chi-Square Distribution, Child, Creatinine, Delayed Graft Function, Female, Graft Rejection, Graft Survival, Humans, Kaplan-Meier Estimate, Kidney Transplantation, Living Donors, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Poverty Areas, Proportional Hazards Models, Retrospective Studies, Risk Factors, Scotland, Time Factors, Treatment Outcome, Young Adult