| Title |
Racial–ethnic disparities in mortality and kidney transplant outcomes among pediatric dialysis patients
|
|---|---|
| Published in |
Pediatric Nephrology, October 2016
|
| DOI | 10.1007/s00467-016-3530-2 |
| Pubmed ID | |
| Authors |
Marciana Laster, Melissa Soohoo, Clinton Hall, Elani Streja, Connie M. Rhee, Vanessa A. Ravel, Uttam Reddy, Keith C. Norris, Isidro B. Salusky, Kamyar Kalantar-Zadeh |
| Abstract |
Previous studies in adult hemodialysis patients have shown that African-American and Hispanic patients have a lower risk of mortality in addition to a lower likelihood of kidney transplantation. However, studies of the association between race and outcomes in pediatric dialysis are sparse and often do not examine outcomes in Hispanic children. The objective was to determine if racial-ethnic disparities in mortality and kidney transplantation outcomes exist in pediatric dialysis patients. This was a retrospective cohort analysis of 2,697 pediatric dialysis patients (aged 0-20 years) from a large national dialysis organization (entry period 2001-2011) of non-Hispanic white, African-American, and Hispanic race-ethnicity. Associations between race-ethnicity with mortality and kidney transplantation outcomes were examined separately using competing risks methods. Logistic regression analyses were used to examine the association between race-ethnicity, with outcomes within 1 year of dialysis initiation. Of the 2,697 pediatric patients in this cohort, 895 were African-American, 778 were Hispanic, and 1,024 were non-Hispanic white. After adjusting for baseline demographics, competing risk survival analysis revealed that compared with non-Hispanic whites, African-Americans had a 64 % higher mortality risk (hazards ratio [HR] = 1.64; 95 % CI 1.24-2.17), whereas Hispanics had a 31 % lower mortality risk (HR = 0.69; 95 % CI 0.47-1.01) that did not reach statistical significance. African-Americans also had higher odds of 1-year mortality after starting dialysis (odds ratio [OR] = 2.08; 95 % CI 0.95-4.58), whereas both African-Americans and Hispanics had a lower odds of receiving a transplant within 1 year of starting dialysis (OR = 0.28; 95 % CI 0.19-0.41 and OR = 0.43; 95 % CI 0.31-0.59 respectively). In contrast to adults, African-American pediatric dialysis patients have worse survival than their non-Hispanic white counterparts, whereas Hispanics have a similar to lower mortality risk. Both African-American and Hispanic pediatric dialysis patients had a lower likelihood of kidney transplantation than non-Hispanic whites, similar to observations in the adult dialysis population. |
X Demographics
The data shown below were collected from the profiles of 13 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 23% |
| Netherlands | 1 | 8% |
| Ireland | 1 | 8% |
| United Kingdom | 1 | 8% |
| Unknown | 7 | 54% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 7 | 54% |
| Scientists | 3 | 23% |
| Practitioners (doctors, other healthcare professionals) | 2 | 15% |
| Science communicators (journalists, bloggers, editors) | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 6 | 14% |
| Student > Master | 6 | 14% |
| Student > Ph. D. Student | 5 | 12% |
| Student > Postgraduate | 4 | 9% |
| Student > Bachelor | 3 | 7% |
| Other | 10 | 23% |
| Unknown | 9 | 21% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 47% |
| Nursing and Health Professions | 3 | 7% |
| Agricultural and Biological Sciences | 3 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Psychology | 2 | 5% |
| Other | 3 | 7% |
| Unknown | 10 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 May 2018.
All research outputs
#4,379,918
of 24,631,014 outputs
Outputs from Pediatric Nephrology
#669
of 3,911 outputs
Outputs of similar age
#67,889
of 318,875 outputs
Outputs of similar age from Pediatric Nephrology
#6
of 73 outputs
Altmetric has tracked 24,631,014 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,911 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 318,875 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 73 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.