Clinical outcomes and survival in pediatric patients initiating chronic dialysis: a report of the NAPRTCS registry

Weaver, Donald J.; Somers, Michael J.; Martz, Karen; Mitsnefes, Mark

doi:10.1007/s00467-017-3759-4

Cited by 101 publications

(59 citation statements)

References 37 publications

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“…Another major concern in children undergoing chronic hemodialysis is the associated PEM and stunting. The NAPRTCS (North American Pediatric Renal Transplant Cooperative Study) registry report on “Clinical outcomes and survival in pediatric patients initiating chronic dialysis” demonstrated that although there was nearly a 7% decrease from the previous decade, about 33% of the children who initiated dialysis during the decade of 2002‐2011 continued to have height < 2 SDS . An improvement in linear growth, as well as relaxation of fluid and dietary restrictions leading to an overall improvement in the nutritional status, has been demonstrated in many small cohorts of pediatric patients undergoing intensified HD regimens.…”

Section: Advantages Of Intensified Hdmentioning

confidence: 99%

Nocturnal home hemodialysis in children: Advantages, implementation, and barriers

Grewal

Mehta²,

Chakraborty

et al. 2020

Seminars in Dialysis

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Chronic kidney disease and end‐stage renal disease (ESRD) in children are major health concerns worldwide with increasing incidence and prevalence. Renal replacement therapies and kidney transplants have remarkably improved the management of patients with ESRD in both adult and pediatric populations. Kidney transplant has the best patient outcomes, but many a time it has a considerable waiting period. In the meantime, the majority of patients with pediatric ESRD are dependent on dialysis. The conventionally utilized hemodialysis regimen is the three times weekly, in‐center hemodialysis. Many studies have demonstrated the unfavorable long‐term morbidity associated with the conventional regimen. Intensified dialysis programs, which include extended nocturnal hemodialysis or short daily hemodialysis, are being increasingly advocated over the past two decades. In addition to having much better clinical outcomes as compared with the conventional regimen, the flexibility to provide dialysis at home serves as a great incentive. PubMed/Medline, Embase and Cochrane databases for literature on nocturnal home hemodialysis in children with ESRD were extensively searched. Contrary to the noticeable literature available on adult home hemodialysis, a small number of studies exist in the pediatric population. In this review, the benefits, implementation and associated barriers of nocturnal home hemodialysis in children were addressed.

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Section: Advantages Of Intensified Hdmentioning

confidence: 99%

Nocturnal home hemodialysis in children: Advantages, implementation, and barriers

Grewal

Mehta²,

Chakraborty

et al. 2020

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…Additionally, mortality was noted to be in a U-shaped curve, with greater risks with very high or very low body mass indexes (BMI)'s. The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) data also shows poor survival with very short stature as well as poor outcomes when starting renal replacement if pre-dialysis linear growth is very poor (9). In 2016, Ku et al (10) affirmed previous findings by Wong, also showing that poor height is correlated with reduced chance of kidney transplant.…”

Section: Impact Of Nutrition On Growth In Ckdmentioning

confidence: 99%

“…Children younger than age two often have the greater growth deficits and lower BMI's are noted for children under the age of five, while children older than five have higher BMI's, especially if CKD course was at an older age (11). However, children younger than age two also have the greatest chance of catch up growth while on dialysis (9). Enteral nutrition and supplemental feeding is a significant factor in these children's ability to meet adequate caloric intake and achieve catch up growth (12).…”

Section: Impact Of Nutrition On Growth In Ckdmentioning

confidence: 99%

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

Nelms

2018

Front. Pediatr.

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Growth in pediatric Chronic Kidney Disease is important for long-term outcomes including final adult height and cognitive function. However, there are many barriers for children with chronic kidney disease to achieve adequate nutritional intake to optimize growth. This review highlights these unique concerns, including route of nutrition, dialysis contributions and biochemical indices. Fitting the enteral feeding to the patients' needs involves choosing an appropriate product or products, limiting harmful nutrients in excess, notably aluminum, and altering for electrolyte and micronutrient needs. Unique adjustments to the enteral regimen include accommodating volume needs, optimizing macronutrient ratios, specific electrolyte adjustments, the blending of products together, and adjustments made to consider patient and family psychosocial needs. When a holistic approach to medical nutrition therapy is applied, taking the above factors into consideration, adequate intake for growth of the child with CKD is achievable.

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“…Most causes of pediatric OU are congenital and impact nephrogenesis and kidney maturation, contributing significantly to pediatric chronic kidney disease (CKD) and end-stage renal disease (ESRD) [1]. Population studies estimate that OU accounts for 16.5% of children with kidney transplants and 13% of children receiving dialysis [2, 3]. Despite continued improvement in techniques for early diagnosis and management of OU in both the prenatal and postnatal periods, a significant number of these children still progress to ESRD [4–7].…”

Section: Introductionmentioning

confidence: 99%

Common clinical markers predict end-stage renal disease in children with obstructive uropathy

et al. 2018

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Background Obstructive uropathy (OU) is a common cause of end-stage renal disease (ESRD) in children. Children who escape the newborn period with mild-to-moderate chronic kidney disease (CKD) continue to be at increased risk. The predictive ability of clinically available markers throughout childhood is poorly defined. Methods Patients with OU were identified in the Chronic Kidney Disease in Children Study. The primary outcome of interest was renal replacement therapy (RRT) (cases). Controls were age matched and defined as patients within the OU cohort who did not require RRT during study follow-up. Results In total, 27 cases and 41 age-matched controls were identified. Median age at baseline and age at outcome measurement were 10 vs. 16 years, respectively. First available glomerular filtration rate (GFR) (36.9 vs. 53.5 mL/min per 1.73 m2), urine protein/creatinine (Cr) (0.40 vs. 0.22 mg/mg) and microalbumin/Cr (0.58 vs. 0.03 mg/mg), and serum CO2 (20 vs. 22 mmol/L) and hemoglobin (12.4 vs. 13.2 g/dL) differed significantly between cases and controls, respectively. GFR declined 3.07 mL/min per 1.73 m2/year faster in cases compared to that in controls (p < 0.0001). Urine protein/Cr and microalbumin/Cr increased by 0.16 and 0.11 per year more in cases compared to those in controls, respectively (p ≤ 0.001 for both). Serum phosphate increased by 0.11 mg/dL and serum albumin and hemoglobin decreased by 0.04 (g/dL) and 0.14 (g/dL) per year more for cases compared to those for controls, respectively (p < 0.05 for all). Conclusions Age-specific baseline and longitudinal measures of readily available clinical measures predict progression to ESRD in children with mild-to-moderate CKD from OU.

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Clinical outcomes and survival in pediatric patients initiating chronic dialysis: a report of the NAPRTCS registry

Abstract: The survival of pediatric patients on chronic dialysis has improved over two decades of dialysis registry data, specifically for children <1year.

Cited by 101 publications

References 37 publications

Nocturnal home hemodialysis in children: Advantages, implementation, and barriers

Nocturnal home hemodialysis in children: Advantages, implementation, and barriers

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

Common clinical markers predict end-stage renal disease in children with obstructive uropathy

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