Kidney Week

Abstract: FR-PO1022

Barriers to Participation in CKD Clinical Trials: A 25-City Analysis

Session Information

• Social, Environmental, and Economic Determinants of Kidney Health
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Cojuc, Gabriel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Gabriel Cojuc, MD

• Braverman-Poyastro, Alan, Red de Universidades Anahuac, Naucalpan de Juarez, Mexico, Mexico

Alan Braverman-Poyastro

• De Las Fuentes, Alejandra, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Nuevo León, Mexico

Alejandra De Las Fuentes

• Rodriguez-Paniagua, Briana, Universidad Panamericana, Ciudad de Mexico, Ciudad de México, Mexico

Briana Rodriguez-Paniagua

• Mizrahi Drijanski, Andrea, Red de Universidades Anahuac, Naucalpan de Juarez, Mexico, Mexico

Andrea Mizrahi Drijanski

• Nordmann-Gomes, Alberto, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Alberto Nordmann-Gomes, MD

• Moscona-Nissan, Alberto, Universidad Panamericana, Ciudad de Mexico, Ciudad de México, Mexico

Alberto Moscona-Nissan

• Guijosa, Alberto, Universidad Panamericana, Ciudad de Mexico, Ciudad de México, Mexico

Alberto Guijosa, MBBS

• Tinajero Sánchez, Denisse Nayely, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Denisse Nayely Tinajero Sánchez, MD

• Canaviri, Vianca Anabel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Vianca Anabel Canaviri, APN

• Chopra, Bhavna, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

Bhavna Chopra, MD, FASN

• Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Ricardo Correa-Rotter, MD

• Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Juan Carlos Ramirez-Sandoval, MD, PhD

Background

Access to healthcare among those with limited resources, alongside several other factors, may influence participation in randomized controlled trials (RCTs). We aimed to identify barriers to CKD RCT participation in the cities from the Global Observatory of Healthy and Sustainable Cities (GOHSC).

Methods

Cross-sectional study of 214 pharmacologic CKD RCTs published between 2003-2023 and including participants from 146 GOHSC research sites. We obtained indicators from WHO, GOHSC, ISN-GKHA, and GBD. We developed a three-point CKD research capacity scale with six variables (population-weighted RCTs, sites/km², funding, site span, facility type, RCTs/site). We classified research capacity as absent (0-1 points), insufficient (2-4), fair (6-7), good (7-8), or excellent (9-10) and compared financial, urban, and healthcare variables across categories.

Results

Odense had the highest population-weighted RCTs (7.01 RCTs/100,000 population), and Mexico City had the lowest (0.06). Compared with cities with absent or insufficient research capacity, those with good or excellent research capacity, had higher health expenditures, more nephrologists, public CKD care coverage, and dialysis centers. We identified non-traditional barriers to CKD RCT participation. Daily living score, access to public transport, open space, and a fresh food market were higher in cities with better research capacity.

Conclusion

Urban, financial, and healthcare barriers may affect RCT participation in the GOHSC. International initiatives should address local disparities in CKD research capacity.

Research capacity scale results