Long-term all-cause mortality and cardiovascular outcomes in Scottish children after initiation of renal replacement therapy: a national cohort study

Galiyeva, Dinara; Jackson, Caroline; Burns, Susan E.; Hughes, David; Traynor, Jamie P.; Metcalfe, Wendy; Halbesma, Nynke

doi:10.1007/s00467-019-04430-4

Cited by 9 publications

(7 citation statements)

References 32 publications

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“…While this incident rate is much higher than the general population, it is not as high as the rates reported in other ESKD cohorts. By comparison, a recent study of a Scottish population who had commenced RRT during childhood reported an ~55% higher incidence of cardiovascular events compared with our cohort 9 . Notably the Scottish cohort had a crude overall mortality rate 25% greater than our Australian cohort which is likely to also account for some of the difference.…”

Section: Discussioncontrasting

confidence: 83%

“…The discrepancy in the type of outcome associated each variable cannot be readily explained. Lack of transplant during follow‐up was also identified by Galiyeva et al as a vascular risk factor 9 . In Australia, deceased donor transplant allocation bonuses have been available to those less than 18 years of age from 2000.…”

Section: Discussionmentioning

confidence: 94%

“…The Scottish analysis linked registry data to national death and hospital records and therefore may have ascertained cases that were not reported in the ESKD registry. While we attempted to correlate ANZDATA cause of death coding with ICD classification which was used to define cardiovascular mortality by Galiyeva et al, 9 it must be acknowledged that ANZDATA cause of death has previously been shown to poorly correlate with the National Australian death index 12 . It should also be noted that past ANZDATA reports of cardiovascular mortality cannot be directly compared with our analysis.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and predictors of vascular events following end‐stage kidney disease in childhood

et al. 2021

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Aim Cardiovascular death is a leading cause of mortality in paediatric end‐stage kidney disease (ESKD). There is however little known about the clinically relevant vascular disease in this population. We aimed to describe the incidence of new onset vascular disease and vascular death in Australian children receiving renal replacement therapy (RRT). We also aimed to identify demographic or childhood risk factors for these endpoints, and whether vascular disease predicts mortality. Methods Data on Australian patients who commenced RRT at <18 years of age from 1991 to 2017 were extracted from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA). Multivariable competing risks regression was used to identify factors associated with vascular events. Results A cohort of 1268 patients were followed up for a median of 10.31 years. Vascular disease was reported in 5.4%, and vascular death in 4.1%. The cumulative incidence of any vascular event, that is, disease or death, at 10 and 20 years was 5.5% and 12.8%, respectively. Childhood vascular events were associated with non‐Caucasian, non‐Indigenous ethnicity, and for the 804 patients followed up after 18 years of age, vascular events were associated with lack of childhood transplantation, longer childhood dialysis duration and Indigenous ethnicity. Vascular disease was only reported for 25.49% of patients who had a vascular death, and although a significant risk factor for mortality, it had limited ability to predict mortality. Conclusion Cumulative incidence of vascular events is significant after commencing RRT during childhood and is associated with ethnicity, longer childhood dialysis duration and lack of childhood transplantation.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Incidence and predictors of vascular events following end‐stage kidney disease in childhood

et al. 2021

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“…Kidney transplantation (KT) is the treatment of choice for children with end-stage kidney disease (ESKD) as it offers better survival and quality of life compared to treatment with dialysis ( 1 , 2 ). Preemptive kidney transplantation (PKT) is performed before the initiation of dialysis to avoid the morbidity and mortality associated with dialysis ( 3 , 4 ). Whether or not PKT also leads to improved clinical outcomes has been addressed by several studies but these report mixed findings.…”

Section: Introductionmentioning

confidence: 99%

Is Preemptive Kidney Transplantation Associated With Improved Outcomes when Compared to Non-preemptive Kidney Transplantation in Children? A Systematic Review and Meta-Analysis

Magar¹,

Knight²,

Stojanović

et al. 2022

Transpl Int

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Main Problem: Preemptive kidney transplantation (PKT) is performed prior to dialysis initiation to avoid dialysis-related morbidity and mortality in children and adolescents. We undertook a systematic review to compare clinical outcomes in PKT versus kidney transplantation after dialysis initiation in paediatric patients.Methods: The bibliographic search identified studies that compared paediatric recipients of a first or subsequent, living or deceased donor PKT versus non-preemptive kidney transplant. Methodological quality was assessed for all studies. Data were pooled using the random-effects model.Results: Twenty-two studies (n = 22,622) were included. PKT reduced the risk of overall graft loss (relative risk (RR) .57, 95% CI: .49–.66) and acute rejection (RR: .81, 95% CI: .75–.88) compared to transplantation after dialysis. Although no significant difference was observed in overall patient mortality, the risk of patient death was found to be significantly lower in PKT patients with living donor transplants (RR: .53, 95% CI: .34–.83). No significant difference was observed in the incidence of delayed graft function.Conclusion: Evidence from observational studies suggests that PKT is associated with a reduction in the risk of acute rejection and graft loss. Efforts should be made to promote and improve rates of PKT in this group of patients (PROSPERO).Systematic Review Registration:https://clinicaltrials.gov/, CRD42014010565

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“…In recent years, both the prevalence and incidence of chronic kidney disease (CKD) in children have increased ( 1 ). Unlike adult patients, the most common causes of CKD in children are congenital malformations; but the increase in overweight/obesity in children may be a contributing factor as well ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Adipokines as predictive factor of cardiac function in pediatric patients with chronic kidney disease

et al. 2023

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BackgroundAdipokines are associated with cardiovascular disease; in chronic kidney disease (CKD) patients adipokines could be useful prognostic factors.ObjectivesTo explore whether leptin and adiponectin in kidney replacement therapy (KRT) children could have a role on their cardiac function, in the long-term.DesignProspective cohort study was performed with pediatric KRT patients, aged 8 to 17 years who were undergoing hemodialysis or peritoneal dialysis. At enrollment, lipid profile, adipokines (leptin, leptin receptor, free leptin, and adiponectin), anthropometric measurements and cardiological evaluation were determined. At two-year follow-up, a new cardiological evaluation was performed. Statistical analysis: Quantitative data are presented as median and interquartile range (IQR). Mann-Whitney U test and Chi-squared were used for the between-group comparison. Multivariate analyzes were performed to determine the association of adipokines levels with ventricular ejection fraction (LEVF).ResultsWe included 56 patients, with a median age of 12.5 years. In the first cardiological evaluation, median LVEF was 70.0% (IQR 61%, 76%), 20 patients (35.7%) had some cardiovascular condition, and 10 (17.8%) altered LVEF. At 24-month follow-up, the median LVEF was 70.5% (IQR 65.1%, 77%), while the delta-LVEF values was 3% (IQR -6.5%, 7%). Delta-LVEF were correlated with baseline adipokines serum levels, and the only positive correlation found was with free leptin (r=0.303, p=0.025). In multivariate analysis, levels of free leptin (Coef. 0.12, p<0.036) and leptin (coef. 1.72, p=0.049), as well as baseline LVEF (Coef. -0.65, p<0.001) were associated with delta-LVEF.ConclusionsFree leptin, leptin and LVEF at the beginning of follow-up were associated with the LVEF decrease at the 24-month follow-up in KRT children.

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Long-term all-cause mortality and cardiovascular outcomes in Scottish children after initiation of renal replacement therapy: a national cohort study

Cited by 9 publications

References 32 publications

Incidence and predictors of vascular events following end‐stage kidney disease in childhood

Incidence and predictors of vascular events following end‐stage kidney disease in childhood

Is Preemptive Kidney Transplantation Associated With Improved Outcomes when Compared to Non-preemptive Kidney Transplantation in Children? A Systematic Review and Meta-Analysis

Adipokines as predictive factor of cardiac function in pediatric patients with chronic kidney disease

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