Social Deprivation and Incidence of Pediatric Kidney Failure in France

Introduction: Approximately 8 per million children and young adults aged < 20 years initiate kidney replacement therapy (KRT) per year in France. We hypothesize that social deprivation could be a determinant of childhood-onset kidney failure. The objective of this study was to estimate the incide...

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Main Authors: Bénédicte Driollet, Cécile Couchoud, Justine Bacchetta, Olivia Boyer, Julien Hogan, Denis Morin, François Nobili, Michel Tsimaratos, Etienne Bérard, Florian Bayer, Ludivine Launay, Karen Leffondré, Jérôme Harambat
Format: Article
Language:English
Published: Elsevier 2024-07-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924016772
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author Bénédicte Driollet
Cécile Couchoud
Justine Bacchetta
Olivia Boyer
Julien Hogan
Denis Morin
François Nobili
Michel Tsimaratos
Etienne Bérard
Florian Bayer
Ludivine Launay
Karen Leffondré
Jérôme Harambat
author_facet Bénédicte Driollet
Cécile Couchoud
Justine Bacchetta
Olivia Boyer
Julien Hogan
Denis Morin
François Nobili
Michel Tsimaratos
Etienne Bérard
Florian Bayer
Ludivine Launay
Karen Leffondré
Jérôme Harambat
author_sort Bénédicte Driollet
collection DOAJ
description Introduction: Approximately 8 per million children and young adults aged < 20 years initiate kidney replacement therapy (KRT) per year in France. We hypothesize that social deprivation could be a determinant of childhood-onset kidney failure. The objective of this study was to estimate the incidence of pediatric KRT in France according to the level of social deprivation. Methods: All patients < 20 years who initiated KRT from 2010 to 2015 in metropolitan France were included. Data were collected from the comprehensive French registry of KRT French Renal Epidemiology and Information network (REIN). We used a validated ecological index to assess social deprivation, the 2011 French version of the European Deprivation Index (EDI). We estimated the age standardized incidence rates according to the quintiles of EDI using direct standardization and incidence rate ratio using Poisson regression. Results: We included 672 children with kidney failure (58.6% males, 30.7% with glomerular or vascular disease, 43.3% starting KRT between 11 and 17 years). 38.8% were from the most deprived areas (quintile 5 of EDI). The age standardized incidence rate increased with quintile of EDI, from 5.45 (95% confidence interval [CI] = 4.25–6.64) per million children per year in the least deprived quintile to 8.46 (95% CI = 7.41–9.51) in the most deprived quintile of EDI (incidence rates ratio Q5 vs. Q1 1.53-fold; 95% CI = 1.18–2.01). Conclusion: This study showed that even in a country with a universal health care system, there is a strong association between the incidence of pediatric KRT and social deprivation showing that social health inequalities appear from KRT initiation. This study highlights the need to look further into social inequalities in the earliest stage of chronic kidney disease (CKD).
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spelling doaj-art-594615c7c02b428a9df3cd2a9a0704762025-08-20T02:06:12ZengElsevierKidney International Reports2468-02492024-07-01972269227710.1016/j.ekir.2024.04.042Social Deprivation and Incidence of Pediatric Kidney Failure in FranceBénédicte Driollet0Cécile Couchoud1Justine Bacchetta2Olivia Boyer3Julien Hogan4Denis Morin5François Nobili6Michel Tsimaratos7Etienne Bérard8Florian Bayer9Ludivine Launay10Karen Leffondré11Jérôme Harambat12University of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France; INSERM, Clinical Investigation Center-Clinical Epidemiology CIC-1401, Bordeaux, France; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada; Correspondence: Bénédicte Driollet, University of McGill, 2001 avenue McGill College, Suite 1200, Montreal, Quebec H3A 1G1, Canada.REIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, FrancePediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Nephrogones, Femme Mère Enfants Hospital, Hospices Civils de Lyon, Bron, FrancePediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares MARHEA, Necker-Enfants Malades Hospital, Imagine Institute, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, Paris, FrancePediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Marhea, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FrancePediatric Nephrology Unit, Centre de Référence des Maladies Rénales Rares Sorare, Arnaud de Villeneuve Hospital, Montpellier University Hospital, Montpellier, FranceDepartment of Pediatrics, Besançon University Hospital, Besançon, FranceREIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, France; Pediatric Nephrology Unit, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, FranceDepartment of Pediatrics, Nice University Hospital, Nice, FranceREIN registry, Agence de la Biomédecine, La Plaine-Saint Denis, FranceINSERM-UCN U1086 Anticipe, Equipe Labellisée Ligue Contre le Cancer, Centre de Lutte contre le Cancer François Baclesse, Caen, FranceUniversity of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France; INSERM, Clinical Investigation Center-Clinical Epidemiology CIC-1401, Bordeaux, FranceUniversity of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France; INSERM, Clinical Investigation Center-Clinical Epidemiology CIC-1401, Bordeaux, France; Pediatric Nephrology Unit, Centre de Référence Maladies rénales rares Sorare, Pellegrin-Enfants Hospital, Bordeaux University Hospital, Bordeaux, FranceIntroduction: Approximately 8 per million children and young adults aged < 20 years initiate kidney replacement therapy (KRT) per year in France. We hypothesize that social deprivation could be a determinant of childhood-onset kidney failure. The objective of this study was to estimate the incidence of pediatric KRT in France according to the level of social deprivation. Methods: All patients < 20 years who initiated KRT from 2010 to 2015 in metropolitan France were included. Data were collected from the comprehensive French registry of KRT French Renal Epidemiology and Information network (REIN). We used a validated ecological index to assess social deprivation, the 2011 French version of the European Deprivation Index (EDI). We estimated the age standardized incidence rates according to the quintiles of EDI using direct standardization and incidence rate ratio using Poisson regression. Results: We included 672 children with kidney failure (58.6% males, 30.7% with glomerular or vascular disease, 43.3% starting KRT between 11 and 17 years). 38.8% were from the most deprived areas (quintile 5 of EDI). The age standardized incidence rate increased with quintile of EDI, from 5.45 (95% confidence interval [CI] = 4.25–6.64) per million children per year in the least deprived quintile to 8.46 (95% CI = 7.41–9.51) in the most deprived quintile of EDI (incidence rates ratio Q5 vs. Q1 1.53-fold; 95% CI = 1.18–2.01). Conclusion: This study showed that even in a country with a universal health care system, there is a strong association between the incidence of pediatric KRT and social deprivation showing that social health inequalities appear from KRT initiation. This study highlights the need to look further into social inequalities in the earliest stage of chronic kidney disease (CKD).http://www.sciencedirect.com/science/article/pii/S2468024924016772chronic kidney diseaseend-stage kidney diseasefrench edipediatric nephrologysocioeconomic disparities
spellingShingle Bénédicte Driollet
Cécile Couchoud
Justine Bacchetta
Olivia Boyer
Julien Hogan
Denis Morin
François Nobili
Michel Tsimaratos
Etienne Bérard
Florian Bayer
Ludivine Launay
Karen Leffondré
Jérôme Harambat
Social Deprivation and Incidence of Pediatric Kidney Failure in France
Kidney International Reports
chronic kidney disease
end-stage kidney disease
french edi
pediatric nephrology
socioeconomic disparities
title Social Deprivation and Incidence of Pediatric Kidney Failure in France
title_full Social Deprivation and Incidence of Pediatric Kidney Failure in France
title_fullStr Social Deprivation and Incidence of Pediatric Kidney Failure in France
title_full_unstemmed Social Deprivation and Incidence of Pediatric Kidney Failure in France
title_short Social Deprivation and Incidence of Pediatric Kidney Failure in France
title_sort social deprivation and incidence of pediatric kidney failure in france
topic chronic kidney disease
end-stage kidney disease
french edi
pediatric nephrology
socioeconomic disparities
url http://www.sciencedirect.com/science/article/pii/S2468024924016772
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