Educational level as a determinant of access to and outcomes after kidney transplantation in the United States.

摘要: Background Disparities in access to kidney transplantation exist, yet few studies investigated educational level as a determinant of and outcomes after transplantation. Study Design Prospective cohort study. Settings & Participants Nationally representative sample incident US dialysis patients, which 3,245 patients reported their level. Predictor Educational level, categorized some high school, school graduate, college, college graduate. Outcomes Measurements Access was defined time from first treatment to: (1) the day being wait-listed (2) were: (3) all-cause mortality graft failure ([4] [5] death censored). Using Cox regression, we studied relationship between predialysis Results During follow-up, 692 were 670 underwent Of those, 164 died 241 lost allograft (121 nondeath causes). After multivariate adjustment, graduates experienced 3 times greater rates wait-listing (hazard ratio, 2.81; 95% confidence interval, 2.21 3.58) or 3.06; 2.38 3.92) compared with without degree ( P for trend across both trend=0.03). Limitations Not randomized Conclusion The latter finding is novel important requires confirmation. Its possible mechanisms (eg, adherence immunosuppressants) warrant additional