RT Journal Article
SR Electronic
T1 Adverse outcomes among Aboriginal patients receiving peritoneal dialysis
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1433
OP 1439
DO 10.1503/cmaj.100105
VO 182
IS 13
A1 Manish M. Sood
A1 Paul Komenda
A1 Amy R. Sood
A1 Martina Reslerova
A1 Mauro Verrelli
A1 Chris Sathianathan
A1 Loretta Eng
A1 Amanda Eng
A1 Claudio Rigatto
YR 2010
UL http://www.cmaj.ca/content/182/13/1433.abstract
AB Background: The Aboriginal population in Canada experiences high rates of end-stage renal disease and need for dialytic therapies. Our objective was to examine rates of mortality, technique failure and peritonitis among adult aboriginal patients receiving peritoneal dialysis in the province of Manitoba. We also aimed to explore whether differences in these rates may be accounted for by location of residence (i.e., urban versus rural). Methods: We included all adult patients residing in the province of Manitoba who received peritoneal dialysis during the period from 1997–2007 (n = 727). We extracted data from a local administrative database and from the Canadian Organ Replacement Registry and the Peritonitis Organism Exit-sites/Tunnel infections (POET) database. We used Cox and logistic regression models to determine the relationship between outcomes and Aboriginal ethnicity. We performed Kaplan–Meier analyses to examine the relationship between outcomes and urban (i.e., 50 km or less from the primary dialysis centre in Winnipeg) versus rural (i.e., more than 50 km from the centre) residency among patients who were aboriginal. Results: One hundred sixty-one Aboriginal and 566 non-Aboriginal patients were included in the analyses. Adjusted hazard ratios for mortality (HR 1.476, CI 1.073–2.030) and adjusted time to peritonitis (HR 1.785, CI 1.352–2.357) were significantly higher among Aboriginal patients than among non-Aboriginal patients. We found no significant differences in mortality, technique failure or peritonitis between urban- or rural-residing Aboriginal patients. Interpretation: Compared with non-Aboriginal patients receiving peritoneal dialysis, Aboriginal patients receiving peritoneal dialysis had higher mortality and faster time to peritonitis independent of comorbidities and demographic characteristics. This effect was not influenced by place of residence, whether rural or urban.