title: Incidence and causes of end-stage renal disease among Aboriginal children and young adults.
abstract: BACKGROUND
  Although Aboriginal adults have a higher risk of end-stage renal disease than non-Aboriginal adults, the incidence and causes of end-stage renal disease among Aboriginal children and young adults are not well described.
  
  
  METHODS
  We calculated age- and sex-specific incidences of end-stage renal disease among Aboriginal people less than 22 years of age using data from a national organ failure registry. Incidence rate ratios were used to compare rates between Aboriginal and white Canadians. To contrast causes of end-stage renal disease by ethnicity and age, we calculated the odds of congenital diseases, glomerulonephritis and diabetes for Aboriginal people and compared them with those for white people in the following age strata: 0 to less than 22 years, 22 to less than 40 years, 40 to less than 60 years and older than 60 years.
  
  
  RESULTS
  Incidence rate ratios of end-stage renal disease for Aboriginal children and young adults (age < 22 yr, v. white people) were 1.82 (95% confidence interval [CI] 1.40-2.38) for boys and 3.24 (95% CI 2.60-4.05) for girls. Compared with white people, congenital diseases were less common among Aboriginal people aged less than 22 years (odds ratio [OR] 0.56, 95% CI 0.36-0.86), and glomerulonephritis was more common (OR 2.18, 95% CI 1.55-3.07). An excess of glomerulonephritis, but not diabetes, was seen among Aboriginal people aged 22 to less than 40 years. The converse was true (higher risk of diabetes, lower risk of glomerulonephritis) among Aboriginal people aged 40 years and older.
  
  
  CONCLUSIONS
  The incidence of end-stage renal disease is higher among Aboriginal children and young adults than among white children and young adults. This higher incidence may be driven by an increased risk of glomerulonephritis in this population.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada. s.samuel@albertahealthservices.ca
authors.forename: Susan M
authors.initials: SM
authors.lastname: Samuel
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Foster
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.forename: Alberto
authors.initials: A
authors.lastname: Nettel-Aguirre
authors.forename: Lynden
authors.initials: L
authors.lastname: Crowshoe
authors.forename: R Todd
authors.initials: RT
authors.lastname: Alexander
authors.forename: Andrea
authors.initials: A
authors.lastname: Soo
authors.forename: Marcello A
authors.initials: MA
authors.lastname: Tonelli
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007223:Infant; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000209:etiology; D008297:Male; D044465:White People; D055815:Young Adult