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

Nikki J. Schoenmaker, Wilma F. Tromp, Johanna H. van der Lee, Brigitte Adams, Antonia H. Bouts, Laure Collard, Karlien Cransberg, Rita van Damme-Lombaerts, Nathalie Godefroid, Koen J. van Hoeck, Linda Koster-Kamphuis, Marc R. Lilien, Ann Raes, Jaap W. Groothoff

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21 Citations (Scopus)

Abstract

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. 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. 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. 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
Original languageEnglish
Pages (from-to)1369-1379
JournalPediatric nephrology (Berlin, Germany)
Volume27
Issue number8
DOIs
Publication statusPublished - 2012

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