Ethnic disparity in outcomes for pediatric peritoneal dialysis patients in the ESRD Clinical Performance Measures Project

Pediatr Nephrol. 2007 Nov;22(11):1939-46. doi: 10.1007/s00467-007-0593-0. Epub 2007 Sep 18.

Abstract

Ethnicity information was collected for all pediatric peritoneal dialysis patients from the End-Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) Project for the period October 2004 through March 2005. Associations between intermediate outcomes and Hispanic ethnicity were determined. Thirty percent (207/696) of patients in the final cohort were Hispanic, 24% (165/696) non-Hispanic black, and 46% (324/696) non-Hispanic white. Hispanics were more likely to be female, older, and have a lower mean height standard deviation score (SDS). There were no significant differences among ethnic/racial groups regarding clearance parameters. More Hispanics had a mean hemoglobin > or = 11 g/dl compared with non-Hispanic blacks and non-Hispanic whites (77% vs. 55% and 70%, P < 0.0001). More Hispanics compared with non-Hispanic blacks and non-Hispanic whites had a mean serum albumin > or = 4.0/3.7 g/dl [bromcresol green/bromcresol purple laboratory method (BCG/BCP)] (50% vs. 24% and 27%, respectively, P < 0.0001). In multivariate analyses, Hispanics remained significantly more likely to achieve a mean serum albumin > or = 4.0/3.7 g/dl (BCG/BCP) compared with non-Hispanic whites (referent) and were as likely to achieve clearance and hemoglobin targets. Pediatric Hispanic peritoneal dialysis patients experience equivalent or better intermediate outcomes of dialytic care compared with non-Hispanics. Further study is needed to understand associations of Hispanic ethnicity with outcomes such as hospitalization, transplantation, and mortality.

MeSH terms

  • Adolescent
  • Black People / statistics & numerical data
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Healthcare Disparities*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Multivariate Analysis
  • Renal Replacement Therapy / statistics & numerical data*
  • Treatment Outcome
  • White People / statistics & numerical data