Pediatric Nephrology
Volume 27, Issue 8, 2012, Pages 1369-1379

Disparities in dialysis treatment and outcomes for Dutch and Belgian children with immigrant parents (Article) (Open Access)

Schoenmaker N.J.* , Tromp W.F. , Van Der Lee J.H. , Adams B. , Bouts A.H. , Collard L. , Cransberg K. , Van Damme-Lombaerts R. , Godefroid N. , Van Hoeck K.J. , Koster-Kamphuis L. , Lilien M.R. , Raes A. , Groothoff J.W.
  • a Department of Pediatric Nephrology, Emma Children's Hospital AMC Amsterdam, Amsterdam, Netherlands
  • b Department of Pediatric Nephrology, Emma Children's Hospital AMC Amsterdam, Amsterdam, Netherlands
  • c Department of Pediatric Clinical Epidemiology, Emma Children's Hospital AMC Amsterdam, Amsterdam, Netherlands
  • d Department of Pediatric Nephrology, Hospital Université des Enfants Reine Fabiola Brussels, Brussels, Belgium
  • e Department of Pediatric Nephrology, Emma Children's Hospital AMC Amsterdam, Amsterdam, Netherlands
  • f Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Liege, Liege, Belgium
  • g Department of Pediatric Nephrology, Sophia Children's Hospital, Erasmus MC Rotterdam, Rotterdam, Netherlands
  • h Department of Pediatric Nephrology, University Hospital Leuven, Leuven, Belgium
  • i Department of Pediatric Nephrology, Université Catholique de Louvain Brussels, Brussels, Belgium
  • j Department of Pediatric Nephrology, University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
  • k Department of Pediatric Nephrology, University Medical Center St Radboud Nijmegen, Nijmegen, Netherlands
  • l Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
  • m Department of Pediatric Nephrology, University Hospital Gent, Gent, Belgium
  • n Department of Pediatric Nephrology, Emma Children's Hospital AMC Amsterdam, Amsterdam, Netherlands

Abstract

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 hemodi-alysis (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% ofWestern 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. © 2011 IPNA.

Author Keywords

End-stage renal disease Renal osteodystrophy Children with immigrant parents Non-Western European Dialysis

Index Keywords

Parents Netherlands dialysis immigrant Kaplan-Meier Estimate renal osteodystrophy long term care human priority journal school child treatment duration Humans Treatment Outcome Adolescent male Emigrants and Immigrants peritoneal dialysis female preschool child hemodialysis Infant newborn Renal Dialysis peritonitis Belgium Article major clinical study adult Kidney Failure, Chronic kidney failure health care quality Kidney Transplantation outcome assessment infection Healthcare Disparities health care disparity Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84863981450&doi=10.1007%2fs00467-012-2135-7&partnerID=40&md5=e280664baa8fc216fa1ad4468d0c6e82
DOI: 10.1007/s00467-012-2135-7
ISSN: 0931041X
Cited by: 11
Original Language: English