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Disparities in dialysis treatment and outcomes for Dutch and Belgian children with immigrant parents.

Schoenmaker, Nikki J; Tromp, Wilma F; van der Lee, Johanna H; Adams, Brigitte; Bouts, Antonia H; Collard, Laure; Cransberg, Karlien; van Damme-Lombaerts, Rita; Godefroid, Nathalie; van Hoeck, Koen J; Koster-Kamphuis, Linda; Lilien, Marc R; Raes, Ann; Groothoff, Jaap W.
Pediatr Nephrol; 27(8): 1369-79, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22434424

BACKGROUND:

In Belgium and the Netherlands, up to 40% of the children on dialysis are children with immigrant parents of non-Western European origin (non-Western). Concerns exist regarding whether these non-Western patients receive the same quality of care as children with parents of Western European origin (Western). We compared initial dialysis, post-initial treatment, and outcomes between non-Western and Western patients on dialysis.

METHODS:

All children <19 years old on chronic dialysis in the Netherlands and Belgium between September 2007 and May 2011 were included in the study. Non-Western patients were defined as children of whom one or both parents were born in non-Western countries.

RESULTS:

Seventy-nine of the 179 included patients (44%) were non-Western children. Compared to Western patients, non-Western patients more often were treated with hemodialysis (HD) instead of peritoneal dialysis (PD) as first dialysis mode (52 vs. 37%, p = 0.046). Before renal transplantation, non-Western patients were on dialysis for a median (range) of 30 (5-99) months, vs. 15 (0-66) months in Western patients (p = 0.007). Renal osteodystrophy was diagnosed in 34% of non-Western vs. 18% of Western patients (p = 0.028). The incidence rate ratio [95% confidence interval] for acute peritonitis was 2.44 [1.43-4.17] (p = 0.032) for non-Western compared to Western patients.

CONCLUSIONS:

There are important disparities between children on chronic dialysis with parents from Western European origin and those from non-Western European origin in the choice of modality, duration, and outcomes of dialysis therapy.
Selo DaSilva