Children of non-Western origin with end-stage renal disease in the Netherlands, Belgium and a part of Germany have impaired health-related quality of life compared with Western children.
BACKGROUND
Many children with end-stage renal disease (ESRD) living in Western Europe are of non-Western European origin. They have unfavourable somatic outcomes compared with ESRD children of Western origin. In this study, we compared the Health-related Quality of Life (HRQoL) of both groups.


METHODS
All children (5-18 years) with ESRD included in the RICH-Q project (Renal Insufficiency therapy in Children-Quality assessment and improvement) or their parents were asked to complete the generic version of the Paediatric Quality-of-Life Inventory 4.0 (PedsQL). RICH-Q comprises the Netherlands, Belgium and a part of Germany. Children were considered to be of non-Western origin if they or at least one parent was born outside Western-European countries. Impaired HRQoL for children with ESRD of Western or non-Western origin was defined as a PedsQL score less than fifth percentile for healthy Dutch children of Western or non-Western origin, respectively.


RESULTS
Of the 259 eligible children, 230 agreed to participate. One hundred and seventy-four children responded (response rate 67%) and 55 (32%) were of non-Western origin. Overall, 31 (56%) of the ESRD children of non-Western origin, and 58 (49%) of Western origin had an impaired total HRQoL score. Total HRQoL scores of children with ESRD of Western origin and non-Western origin were comparable, but scores on emotional functioning and school functioning were lower in non-Western origin (P=0.004 and 0.01, respectively). The adjusted odds ratios (95% confidence interval) for ESRD children of non-Western origin to have impaired emotional functioning and school functioning, compared with Western origin, were 3.3(1.5-7.1) and 2.2(1.1-4.2), respectively.


CONCLUSIONS
Children with ESRD of non-Western origin in three Western countries were found to be at risk for impaired HRQoL on emotional and school functioning. These children warrant special attention.
Department of Paediatric Nephrology, Emma Children's Hospital Academic Medical Centre, Amsterdam, The Netherlands.
Nikki J
NJ
Schoenmaker
Lotte
L
Haverman
Wilma F
WF
Tromp
Johanna H
JH
van der Lee
Martin
M
Offringa
Brigitte
B
Adams
Antonia H M
AH
Bouts
Laure
L
Collard
Karlien
K
Cransberg
Maria
M
van Dyck
Nathalie
N
Godefroid
Koenraad
K
van Hoeck
Linda
L
Koster-Kamphuis
Marc R
MR
Lilien
Ann
A
Raes
Christina
C
Taylan
Martha A
MA
Grootenhuis
Jaap W
JW
Groothoff
D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D017582:Renal Replacement Therapy; D012189:Retrospective Studies
PedsQL; end-stage renal disease; non-Western origin; paediatric nephrology