HealthDay News — For children with end-stage renal disease starting renal replacement therapy (RRT) there is racial disparity in the risk of death, according to a study published online in the Journal of the American Society of Nephrology.

Elaine Ku, MD, from the University of California, San Francisco, and colleagues compared the mortality risk among a cohort of non-Hispanic black, Hispanic, and non-Hispanic white children (12,123 children) who started RRT from 1995 to 2011. The children were followed through 2012. About 25 and 26% of the children were non-Hispanic black and of Hispanic ethnicity, respectively.

The researchers found that during a median follow-up of 7.1 years, 1600 children died. The risk of death was 36% higher for non-Hispanic black children (95% CI, 1.21 to 1.52) and 34% lower for Hispanic children (95% CI, 0.57 to 0.77), compared with non-Hispanic white children. The higher risk of death in non-Hispanic black children was attenuated after adjustment for transplant as a time-dependent covariate (hazard ratio, 0.99; 95% CI, 0.88 to 1.12); the lower risk persisted in Hispanic children (hazard ratio, 0.59; 95% CI, 0.51 to 0.68).

“Parity in access to transplantation in children, and improvements in strategies to prolong graft survival, could substantially reduce disparities in mortality risk of non-Hispanic black children treated with RRT,” the authors write.

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  1. Ku E, McCulloch CE, Grimes BA, Johansen KL. Racial and Ethnic Disparities in Survival of Children with ESRD.  J Am Soc Nephrol. 2016 Dec 29. doi: 10.1681/ASN.2016060706.