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Disparate outcomes in pediatric peritoneal dialysis patients by gender/race in the End-Stage Renal Disease Clinical Performance Measures project

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Abstract

Associations between achievement of adult Kidney Disease Outcomes Quality Initiative (KDOQI) targets for hemoglobin, adequacy and albumin, and race and gender were determined for pediatric peritoneal dialysis patients from the End-Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project for the period October 2004–March 2005. Fifty-six percent (427/761) of patients were male. Sixty-six percent (500/761) of patients were White. There were no differences in achievement of targets for adults by gender, and no differences in adequacy parameters by race. Blacks had lower mean hemoglobin levels than did Whites (11.1 ± 1.6 g/dl vs 11.8 ± 1.4 g/dl, P < 0.0001). Blacks were more likely to have mean hemoglobin levels < 10 g/dl (24% vs 11%, P < 0.0001) and less likely to achieve mean hemoglobin > 11 g/dl (56% vs 72%, P < 0.0001). Whites were more likely to achieve mean serum albumin levels > 4.0/3.7 g/dl [bromocresol green/bromocresol purple (BCG/BCP)] than Blacks were (35% vs 26%, P = 0.0376). In multivariate logistic regression models, White race was associated with mean hemoglobin levels > 11 g/dl [adjusted odds ratio (adjOR) 2.7, 95% confidence interval (CI) 1.7, 4.3] and mean serum albumin > 4.0/3.7 g/dl (BCG/BCP) (adjOR 1.9, 95% CI 1.3, 2.9]. Further study is needed of factors associated with anemia on peritoneal dialysis and barriers to its correction.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Johns Hopkins University, 200 N. Wolfe St., Baltimore, MD, 21287, USA

    Meredith A. Atkinson, Alicia M. Neu & Barbara A. Fivush

  2. Office of Research, Development and Information, Centers for Medicare & Medicaid Services, Baltimore, MD, USA

    Diane L. Frankenfield

Authors
  1. Meredith A. Atkinson
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  2. Alicia M. Neu
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  3. Barbara A. Fivush
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  4. Diane L. Frankenfield
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Correspondence to Meredith A. Atkinson.

Additional information

The views expressed in this manuscript are those of the authors and do not necessarily reflect official policy of the Centers for Medicare & Medicaid Services.

M.A. Atkinson was supported by National Research Service Award training grant T32 HD044355.

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Atkinson, M.A., Neu, A.M., Fivush, B.A. et al. Disparate outcomes in pediatric peritoneal dialysis patients by gender/race in the End-Stage Renal Disease Clinical Performance Measures project. Pediatr Nephrol 23, 1331–1338 (2008). https://doi.org/10.1007/s00467-008-0832-z

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  • DOI: https://doi.org/10.1007/s00467-008-0832-z

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