Rosenberg, Kerry-Lee;
Burns, Aine;
Caplin, Ben;
(2023)
Effect of ethnicity and socioeconomic deprivation on uptake of renal supportive care and dialysis decision making in older adults.
Clinical Kidney Journal
10.1093/ckj/sfad108.
(In press).
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Abstract
Background Renal supportive care has become an increasingly relevant treatment option as the renal patient population ages. Despite the prevalence of kidney disease amongst ethnic minority and socioeconomically deprived patients, evidence focused on supportive care and dialysis decision making in these groups is limited. Methods This retrospective study selected older patients referred to a low clearance or supportive care service between 1 January 2015 and 31 December 2019. A descriptive analysis of clinical and socioeconomic characteristics according to treatment choice was produced and multivariate logistic regression models used to identify predictive factors for choosing supportive care. Surrogate markers for the success of decision making processes were evaluated, including time taken to reach a supportive care decision and risk of death without making a treatment decision or within 3 months of starting kidney replacement therapy (KRT). Finally, the association between ethnicity and socioeconomic status and hospital admission rates were compared between treatment groups. Results Amongst 1768 patients, 515 chose supportive care and 309 chose KRT. Predictive factors for choosing supportive care included age, frailty and a diagnosis of cognitive impairment. However, there was no association with ethnicity or deprivation. Similarly, these factors were not associated with time taken to make a supportive care decision or the mortality outcome. Amongst those on KRT, more socially advantaged patients had decreased rates of hospital admissions compared with those less adavantaged (IRR 0.96, 95% CI 0.92–0.99).
| Type: | Article |
|---|---|
| Title: | Effect of ethnicity and socioeconomic deprivation on uptake of renal supportive care and dialysis decision making in older adults |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ckj/sfad108 |
| Publisher version: | https://doi.org/10.1093/ckj%2Fsfad108 |
| Language: | English |
| Additional information: | This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
| Keywords: | Dialysis decision, elderly, ethnic minorities, renal supportive care, socioeconomic deprivation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10172313 |
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