[en] 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.
Disciplines :
Pediatrics Urology & nephrology
Author, co-author :
Schoenmaker, Nikki J.
Tromp, Wilma F.
van der Lee, Johanna H.
Adams, Brigitte
Bouts, Antonia H.
COLLARD, Laure ; Centre Hospitalier Universitaire de Liège - CHU > Pédiatrie CHR
Centraal Bureau voor de Statistiek (2011) http://www.cbs.nl. Date accessed 1-12-2011
Flores G, Olson L, Tomany-Korman SC (2005) Racial and ethnic disparities in early childhood health and health care. Pediatrics 115:e183-e193 (Pubitemid 43193798)
Lanting LC, Bootsma AH, Lamberts SW, Mackenbach JP, Joung IM (2008) Ethnic differences in internal medicine referrals and diagnosis in the Netherlands. BMC Publ Health 8:287
Stronks K, Ravelli AC, Reijneveld SA (2001) Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health 55:701-707 (Pubitemid 32881816)
van Dellen QM, Stronks K, Bindels PJ, Ory FG, Bruil J, van Aalderen WM (2007) Predictors of asthma control in children from different ethnic origins living in Amsterdam. Respir Med 101:779-785
Tromp WF, van der Lee JH, Offringa M, Bouts AH, Collard L, Cransberg K, Van Damme-Lombaerts R, Godefroid N, Van HK, Koster-Kamphuis L, Lilien MR, Raes A, Groothoff JW (2011) Lessons learned from efforts to improve the quality of care in children with end-stage renal disease in the Netherlands and Belgium. Arch Dis Child 96:1093-1096
Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629-637
Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents (1996) Pediatrics 98:649-658
Boehm M, Winkelmayer WC, Arbeiter K, Mueller T, Aufricht C (2010) Late referral to paediatric renal failure service impairs access to pre-emptive kidney transplantation in children. Arch Dis Child 95:634-638
Tsai HL, Yang LY, Chin TW, Wang HH, Liu CS, Wei CF, Chang JW (2010) Outcome and risk factors for mortality in pediatric peritoneal dialysis. Perit Dial Int 30:233-239
Chan KS, Keeler E, Schonlau M, Rosen M, Mangione-Smith R (2005) How do ethnicity and primary language spoken at home affect management practices and outcomes in children and adolescents with asthma? Arch Pediatr Adolesc Med 159:283-289 (Pubitemid 40321834)
Fischbach M, Terzic J, Menouer S, Provot E, Bergere V (2001) Hemodialysis in children: principles and practice. Semin Nephrol 21:470-479 (Pubitemid 32852765)
Fischbach M, Edefonti A, Schroder C, Watson A (2005) Hemodi-alysis in children: general practical guidelines. Pediatr Nephrol 20:1054-1066 (Pubitemid 41001543)
Furth SL, Powe NR, Hwang W, Neu AM, Fivush BA (1997) Racial differences in choice of dialysis modality for children with end-stage renal disease. Pediatrics 99:E6
Young J, Flores G, Berman S (2004) Providing life-saving health care to undocumented children: controversies and ethical issues. Pediatrics 114:1316-1320 (Pubitemid 41647695)
Hong HW (2009) Somali Immigrants and Health Care: NeoLiberal Globalization in the United States and Holland. 22 ed. http://digitalcommons. macalester.edu/macintl/vol22/iss1/11/
Davis K, Schoen S, Stremikis K (2010) Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update. http://www.commonwealthfund.org/Publications/Fund-Reports/2010/Jun/ Mirror-Mirror-Update.aspx? page=all
Alexander GC, Sehgal AR (1998) Barriers to cadaveric renal transplantation among blacks, women, and the poor. JAMA 280:1148-1152 (Pubitemid 28457804)
Ozminkowski RJ, White AJ, Hassol A, Murphy M (1997) Minimizing racial disparity regarding receipt of a cadaver kidney transplant. Am J Kidney Dis 30:749-759 (Pubitemid 27524336)
Sanfilippo FP, Vaughn WK, Peters TG, Shield CF III, Adams PL, Lorber MI, Williams GM (1992) Factors affecting the waiting time of cadaveric kidney transplant candidates in the United States. JAMA 267:247-252
Furth SL, Garg PP, Neu AM, Hwang W, Fivush BA, Powe NR (2000) Racial differences in access to the kidney transplant waiting list for children and adolescents with end-stage renal disease. Pediatrics 106:756-761
Tromp WF, van der Lee JH, Offringa M, Bouts AH, Collard L, Cransberg K, Van Damme-Lombaerts R, Godefroid N, Van HK, Koster-Kamphuis L, Lilien MR, Raes A, Groothoff JW (2012) Fewer pre-emptive renal transplantations and more rejections in immigrant children compared to native Dutch and Belgian children. Nephrol Dial Transplant. doi:10.1093/ndt/gfr628
Groothoff JW, Offringa M, Van Eck-Smit BL, Gruppen MP, Van De Kar NJ, Wolff ED, Lilien MR, Davin JC, Heymans HS, Dekker FW (2003) Severe bone disease and low bone mineral density after juvenile renal failure. Kidney Int 63:266-275 (Pubitemid 35463930)
Roe S, Cassidy MJ (2000) Diagnosis and monitoring of renal osteodystrophy. Curr Opin Nephrol Hypertens 9:675-681
Fletcher S, Jones RG, Rayner HC, Harnden P, Hordon LD, Aaron JE, Oldroyd B, Brownjohn AM, Turney JH, Smith MA (1997) Assessment of renal osteodystrophy in dialysis patients: use of bone alkaline phosphatase, bone mineral density and parathyroid ultrasound in comparison with bone histology. Nephron 75:412-419 (Pubitemid 27156734)
Rodrigue JR, Cornell DL, Lin JK, Kaplan B, Howard RJ (2007) Increasing live donor kidney transplantation: a randomized controlled trial of a home-based educational intervention. Am J Transplant 7:394-401 (Pubitemid 46096332)
van den Beukel TO, Dekker FW, Siegert CE (2008) Increased survival of immigrant compared to native dialysis patients in an urban setting in the Netherlands. Nephrol Dial Transplant 23:3571-3577
Flores G (2005) The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev 62:255-299 (Pubitemid 40664427)
