title: Family income and survival in Brazilian Peritoneal Dialysis Multicenter Study Patients (BRAZPD): time to revisit a myth?
abstract: OBJECTIVE
  Although low socioeconomic status has been considered a contraindication to peritoneal dialysis (PD), no published data clearly link it to poor outcomes. The goal of this study was assessing the effect of income on survival in the Brazilian Peritoneal Dialysis Multicenter STUDY.
  
  
  METHODS
  Incident PD patients enrolled in this prospective cohort from December 2004 to October 2007 were divided according to monthly family income. The median age was 59 years, 54% were women, 60% Caucasians, 41% diabetics, and 24% had cardiovascular disease. Most of them were in continuous ambulatory PD, had not received predialysis care, had <4 school years, and had a family income of <5 minimum wage (80%). Survival analysis was performed using the Kaplan-Meier method and the Cox proportional hazards model adjusting the results for age, gender, educational status, predialysis care, first therapy, PD modality, calendar year, and comorbidities.
  
  
  RESULTS
  There were no differences in technique (log rank test χ² = 4.36) and patient (log rank test χ² = 2.92) survival between the groups. In the multivariate analysis, low family income remained not associated either to worse technique survival (hazard ratio [HR] = 1.29; 95% confidence interval [CI] = 0.91 to 1.84) or to patient survival (HR = 1.40; 95% CI = 0.99 to 1.99).
  
  
  CONCLUSIONS
  According to these results, economic status is not independently associated with outcomes in this large cohort and should not be considered a barrier for PD indication.
authors.affiliation: Department of Medicine, Federal University of Sergipe, Aracaju, Brazil. kleytonbastos@yahoo.com.br
authors.forename: Kleyton
authors.initials: K
authors.lastname: de Andrade Bastos
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Qureshi
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Lopes
authors.forename: Natália
authors.initials: N
authors.lastname: Fernandes
authors.forename: Luciana Mendonça M
authors.initials: LM
authors.lastname: Barbosa
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
authors.forename: José Carolino
authors.initials: JC
authors.lastname: Divino-Filho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D000075202:Contraindications; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities / Q000191:economics; D006801:Humans; D007182:Income; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010530:Peritoneal Dialysis / Q000401:mortality*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome