Renal Diseases and Social Inequalities in Access to Transplantation in France

Renal diseases are invisible and silent up to an advanced stage. Renal transplant is today the most effective therapy at all ages of life in terms of survival and quality of life, and is also the least expensive for French health system. Yet, whatever their age or sex, patients with a lower level of education less frequently receive transplants. Various independent factors produce these social inequalities: the nature of renal pathologies, resulting partly from patients’ lifestyles; the degree of attention paid to initial symptoms and the existence of two types of replacement therapy (dialysis and transplant) practiced differently in the private and public sectors. Patients with the highest level of education are in a better position to negotiate the system than the others. The results presented in this article are based on data from two national surveys of renal patients conducted in 2011 and 2012