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Abstract: SA-PO389

Neighborhood Socioeconomic Deprivation Among Pediatric Kidney Transplant Recipients

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Douglas, Chloe E., Seattle Children's Hospital, Seattle, Washington, United States
  • Bradford, Miranda, Seattle Children's Research Institute, Seattle, Washington, United States
  • Ng, Yue-Harn, University of Washington School of Medicine, Seattle, Washington, United States
  • Mokiao, Reya H., Seattle Children's Hospital, Seattle, Washington, United States
  • Wightman, Aaron G., Seattle Children's Hospital, Seattle, Washington, United States
  • Engen, Rachel M., University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Smith, Jodi M., Seattle Children's Hospital, Seattle, Washington, United States
Background

Addressing social determinants of health is integral to kidney transplant management, although focus has only recently shifted to neighborhood-level effects. Using data from the Scientific Registry of Transplant Recipients, we describe the association between neighborhood socioeconomic deprivation and graft loss in pediatric kidney transplant recipients.

Methods

US recipients <18 years of age at time of listing who underwent kidney transplantation January 1st, 2010, to May 31st, 2022 (n=9,719) were included. Neighborhood deprivation was calculated using patient ZIP codes at time of listing and the Material Community Deprivation Index (MCDI), ranging from 0 (least deprived) to 1 (most deprived). Recipients were stratified into quintiles (Q). Kaplan-Meier and multivariable Cox proportional hazard estimates were calculated.

Results

The median MCDI for the most deprived neighborhoods (Q5) was 0.53 [IQR: 0.47, 0.84] compared to 0.23 [IQR: 0.06, 0.27] in the least deprived (Q1). Black and Hispanic patients were over-represented in the most deprived neighborhoods. As neighborhood deprivation increased, dialysis duration and deceased donation increased, while preemptive transplantation decreased. Recipients living in the most deprived neighborhoods had a 1.67 times greater risk of graft loss compared to the least deprived (CI: 1.42, 1.98).

Conclusion

Pediatric kidney transplant recipients with the highest levels of neighborhood socioeconomic deprivation had a greater risk of graft loss. Increased focus should be placed on contextual effects of neighborhood environment to address health disparities in pediatric kidney transplantation.

Funding

  • NIDDK Support