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Association Of Marital Status With Access To Renal Transplantation
Authors:M. W. Khattak  G. S. Sandhu  R. Woodward  J. S. Stoff  A. S. Goldfarb‐Rumyantzev
Affiliation:1. Division of Nephrology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA;2. Division of Internal Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA;3. Department of Health Management and Policy and Economics, University of New Hampshire, NH;4. Division of Nephrology, University of Massachusetts Memorial Medical Center, Worcester, MA;5. Transplant Institute, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
Abstract:In this report we evaluated the association of marital status with access to renal transplantation. We analyzed data from the USRDS. In patients with ESRD aged ≥27 (mean age of first marriage in the US), we analyzed the association of marital status with two outcomes: (1) likelihood of being placed on the waiting list for renal transplantation or first transplant, (2) likelihood of receiving kidney transplant in patients already listed. We analyzed marital status as a categorical variable: (1) not married (including never been married and widowed); (2) divorced or separated; and (3) currently married. Subgroups based on age, race, sex, donor type and diabetic status were also analyzed. After adjustments for the included independent variables and compared to individuals never married or widowed, those who were divorced/separated (HR 1.55, p < 0.001) and currently married (HR 1.54, p < 0.001) had a higher likelihood of being placed on the transplant waiting list. Once listed, married individuals had higher chances of getting transplanted as well (HR 1.28, p = 0.033). This trend was consistent in most of the subgroups studied. We demonstrated that being married is associated with better access to renal transplantation compared to those who were never married/widowed.
Keywords:Access  disparities  ESRD  marital status  outcome  renal allograft  renal transplantation
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