Pediatric PD Outcomes Differ By Gender, Race

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Outcomes among pediatric peritoneal dialysis (PD) patients differ by gender and race, according to a study.
 
For example, 71% of white boys met hemoglobin targets compared with only 59% of black boys despite similar time on PD and similar iron stores, erythropoietin dosing, and use of IV iron. The proportions were 74% for white girls and 51% for black girls.

“There is a disproportionate burden of end-stage renal disease among African Americans in this country overall. We know that among adults on dialysis, anemia tends to be more severe among African Americans,” said lead investigator Meredith Atkinson, MD, a third-year pediatric nephrology fellow at Johns Hopkins Medical Institutions in Baltimore.

“Now, we have found that this appears to also be the case for the pediatric peritoneal dialysis population visiting our hospitals.”

She and her colleagues gathered data on 677 PD patients under age 18 years in the United States as part of the end-stage renal disease (ESRD) Clinical Performance Mea-sures (CPM) Project, a national registry. The mean age of the patients was 10 years and the mean time on dialysis was 2.3 years.

According to the study, 54% of white males and 61% of black males had congenital urologic causes of ESRD compared with 39% for white females and 21% for black females.

“We really don't know why these disparities exist,” Dr. Atkinson said. “It may be genetic factors at work. It may be other comorbidities and underlying disease causing ESRD. It may be compliance with medication regimens. All of these factors could be playing a role so now we need to do more research to better understand what is going on.”
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