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

par Schoenmaker, Nikki N.J.;Tromp, Wilma W.F.;Van Der Lee, Johanna J.H.;Adams, Brigitte ;Bouts, Antonia;Collard, Laure;Cransberg, Karlien;Van Damme-Lombaerts, Rita;Godefroid, Nathalie;Van Hoeck, Koenraad;Koster-Kamphuis, Linda;Lilien, Marc M.R.;Raes, Ann;Groothoff, Jaap
Référence Pediatric nephrology, 27, 8, page (1369-1379)
Publication Publié, 2012-08

Article révisé par les pairs

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Résumé :

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.