title: Disparities in dialysis treatment and outcomes for Dutch and Belgian children with immigrant parents.
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 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.
authors.affiliation: Department of Pediatric Nephrology, Emma Children's Hospital AMC Amsterdam, Amsterdam, The Netherlands. n.j.schoenmaker@amc.nl
authors.forename: Nikki J
authors.initials: NJ
authors.lastname: Schoenmaker
authors.forename: Wilma F
authors.initials: WF
authors.lastname: Tromp
authors.forename: Johanna H
authors.initials: JH
authors.lastname: van der Lee
authors.forename: Brigitte
authors.initials: B
authors.lastname: Adams
authors.forename: Antonia H
authors.initials: AH
authors.lastname: Bouts
authors.forename: Laure
authors.initials: L
authors.lastname: Collard
authors.forename: Karlien
authors.initials: K
authors.lastname: Cransberg
authors.forename: Rita
authors.initials: R
authors.lastname: van Damme-Lombaerts
authors.forename: Nathalie
authors.initials: N
authors.lastname: Godefroid
authors.forename: Koen J
authors.initials: KJ
authors.lastname: van Hoeck
authors.forename: Linda
authors.initials: L
authors.lastname: Koster-Kamphuis
authors.forename: Marc R
authors.initials: MR
authors.lastname: Lilien
authors.forename: Ann
authors.initials: A
authors.lastname: Raes
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
mesh_terms: D001530:Belgium; D002648:Child; D054242:Emigrants and Immigrants; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D009426:Netherlands; D010290:Parents; D006435:Renal Dialysis / Q000379:methods* / Q000401:mortality*; D016896:Treatment Outcome