Socioeconomic deprivation is independently associated with mortality post kidney transplantation

Abstract

The association between area socioeconomic deprivation and mortality post kidney transplantation is unclear. To clarify this, we obtained data from 19,103 kidney transplant procedures performed in England from April 2001 to March 2012. Patient demographics included age, gender, donor type (living or deceased), ethnicity, transplant year, allograft failure, medical comorbidities, and area socioeconomic deprivation (Index of Multiple Deprivation (2010)). Primary and secondary outcome measures were 1- and 5-year mortality with Cox proportional hazard models performed to identify independent factors associated with mortality. Data were broken down into quintiles of patients by area socioeconomic deprivation 1 to 5 (most to least deprived, respectively). At 1 year post transplant, 566 deaths were recorded, with infection being the most common cause of death. Compared with the most deprived individuals (reference point), the least deprived recipients had significantly decreased risk of death at 1 and 5 years post kidney transplant (hazard ratio 0.66, 95% CI (0.57-0.76) and hazard ratio 0.65, 95% CI (0.54-0.77), respectively). Thus, socioeconomic deprivation is independently associated with increased mortality post kidney transplantation.