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Aboriginal children less likely to receive kidney transplants, Canadian study finds

Date:
May 24, 2011
Source:
Canadian Medical Association Journal
Summary:
Aboriginal children with kidney failure in Canada were less likely to receive a kidney transplant compared to white children, finds a new article.

Aboriginal children with kidney failure were less likely to receive a kidney transplant compared to white children, found an article in CMAJ (Canadian Medical Association Journal).

Compared with non-Aboriginal people, Aboriginal adults with kidney failure in Canada have lower rates of kidney transplantation, the best treatment for kidney failure. However, there are few studies that have looked at kidney disease and kidney transplantation in Canadian Aboriginal children.

The study, by researchers from the University of Calgary, the Alberta Children's Hospital, McGill University, the Montrιal Children's Hospital, University of Alberta and the Stollery Children's Hospital, consisted of 843 children who began treatment for kidney failure between 1992 and 2007. It included children in 9 of 10 Canadian provinces and all three territories. Of the 843 patients, 12% were Aboriginal and 62% were white children. Aboriginal children had more immune mediated kidney diseases compared to white children. White children had more congenital kidney diseases compared to Aboriginal children.

During the study period, 67.3% of Aboriginal children and 86.8% of white children received kidney transplants. The median time on dialysis before transplantation for Aboriginal children was 1.75 years compared with 0.75 years for white children.

"The time from start of renal replacement treatment to first kidney transplant was longer among Aboriginal children than among white children," writes author Dr. Susan M. Samuel, Department of Pediatrics, Faculty of Medicine, University of Calgary and Alberta Children's Hospital, with co-authors.

"Aboriginal children were 46% less likely to receive a transplant from any source than were white children with the same time elapsed since start of dialysis," write the authors. "In addition, fewer Aboriginal children had pre-emptive transplants [5.8% Aboriginal, 20% white]" -- that is transplantation before undergoing dialysis. Aboriginal children were 64% less likely to receive a living donor kidney transplant and 38% less likely to receive a deceased donor kidney transplant compared with white children.

The lower transplantation rate for Aboriginal children may be due to lower rates of living kidney donation by Aboriginal donors, or a slower process of transplant work-up or delay in initiation of transplant assessment for Aboriginal children. . Various determinants of living donation, including awareness of organ donation in Aboriginal communities, medical suitability of relatives for living donation, and culturally based perspectives influencing organ donation need to be addressed for children.

"Further evaluation is necessary to examine individual and system barriers contributing to longer time to transplantation among Aboriginal children," conclude the authors.


Story Source:

The above story is based on materials provided by Canadian Medical Association Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. Susan M. Samuel, Bethany J. Foster, Marcello A. Tonelli, Alberto Nettel-Aguirre, Andrea Soo, R. Todd Alexander, Lynden Crowshoe, and Brenda R. Hemmelgarn. Dialysis and transplantation among Aboriginal childrenwith kidney failure. Canadian Medical Association Journal, 2011; DOI: 10.1503/cmaj.101840

Cite This Page:

Canadian Medical Association Journal. "Aboriginal children less likely to receive kidney transplants, Canadian study finds." ScienceDaily. ScienceDaily, 24 May 2011. <www.sciencedaily.com/releases/2011/05/110524124039.htm>.
Canadian Medical Association Journal. (2011, May 24). Aboriginal children less likely to receive kidney transplants, Canadian study finds. ScienceDaily. Retrieved April 19, 2014 from www.sciencedaily.com/releases/2011/05/110524124039.htm
Canadian Medical Association Journal. "Aboriginal children less likely to receive kidney transplants, Canadian study finds." ScienceDaily. www.sciencedaily.com/releases/2011/05/110524124039.htm (accessed April 19, 2014).

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