Background Inequalities have been reported in access to kidney transplantation in relation to demographic, socioeconomic, clinical and geographical. Patients waiting for kidney transplant face a number of competitive outcomes.
Objective To investigate factors associated with access to kidney transplantation, considering the type of donor and death as competitive events.
Design and Source of Data observational, prospective non-concurrent, from the National Data Base on renal replacement therapies in Brazil. Relationship was conducted from deterministic-probabilistic System Authorisation Procedures of High Complexity/Cost, Hospital Information System and Information System on Mortality.
Participants 17 084 adult patients starting renal replacement therapy in Brazil from 01/01/2000 to 31/01/2000.
Variables Impact of individual variables (age, gender, region of residence, primary renal disease, hospitalisations) in the context of the dialysis unit (level of complexity, legal, HD machines and location) and the city (geographical region, location and Human Development Index-HDI) in likelihood of transplantation and death.
Results younger patients without diabetes, no history of hospitalisation, in dialysis treatment unit located in the state capital, living in the countryside, in cities with high HDI were more likely to transplant. Sex and level of complexity has only been associated with a living donor transplant. The results indicate differences in access to kidney transplantation, however, regarding gender, age 45 years and diabetes were lower inequality cadaver donor for transplantation. Older patients with diabetes, with hospitalisation, being treated in dialysis units are less complex, located in state capitals and municipalities with low HDI had a higher risk of death.
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