Long-term outcome after renal transplantation in childhood

Rees, Lesley

doi:10.1007/s00467-007-0559-2

Cited by 86 publications

(74 citation statements)

References 79 publications

(176 reference statements)

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“…The aim for our patients is early transplantation, which is believed by most authorities to provide the best option for survival, growth, and psychosocial development (29). This study, like others, shows that transplantation before the age of 2 yr is not associated with a poorer outcome than after this age (24,30 -32).…”

Section: Discussionsupporting

confidence: 63%

Long-Term Outcome of Infants with Severe Chronic Kidney Disease

Mekahli

Shaw

Ledermann

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: In 2000, we reported the outcome of 101 children with a GFR <20 ml/min per 1.73 m 2 at 0.3 yr of age (range 0.0 to 1.5 yr). Long-term data on such young children are scarce.Design, setting, participants, & measurements: Mortality, treatment modalities, and growth were reanalyzed 9.9 yr later. Results: Of the 101 patients, 28 died and three were lost to follow-up during 13.90 yr (range 0.03 to 22.90 yr). One-, 2-, 5-, 10-, 15-, 20-, and 22-yr survivals were 87, 81, 77, 75, 73, 72, and 64%, respectively. Fifty-one children had comorbidities. Sixty-six percent were tube fed for 1.7 yr (range 0.1 to 6.9 yr), 37% had a gastrostomy, and 13% had a Nissen fundoplication. Mean height SD score (SD) was ؊0.42 (2.33) at birth (n ‫؍‬ 40), ؊2.07 (1.34) at 0.5 (n ‫؍‬ 62), ؊1.93 (1.38) at 1 (n ‫؍‬ 72), ؊1.14 (1.14) at 5 (n ‫؍‬ 67), ؊1.04 (1.15) at 10 (n ‫؍‬ 62), ؊1.84 (1.32) at 15 (n ‫؍‬ 40), and ؊1.68 (1.52) at age >18 yr (n ‫؍‬ 32). Comorbidities adversely influenced growth (P < 0.01) and final height (P ‫؍‬ 0.02): Mean height SD score (SD) was ؊1.16 (1.38) in otherwise normal adults.Conclusions: Growth and final height in infants with severe chronic kidney disease are influenced by comorbidity. Intensive feeding and early transplantation resulted in a mean adult height within the normal range in patients without comorbidities. Overall mortality is comparable to that of older children.Clin J Am Soc Nephrol

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Section: Discussionsupporting

confidence: 63%

Long-Term Outcome of Infants with Severe Chronic Kidney Disease

Mekahli

Shaw

Ledermann

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…The negative senescence rates in both groups more likely arise from a sharp decline in mortality rate due to early death of the frailest patients and the selective survival of healthier patients. Particularly in the youngest patients, mortality rates are high due to the underlying renal disease, congenital disorders that are associated with pediatric renal disease, and the complications of dialysis therapy or transplantation (37)(38)(39). The more negative senescence rates in children on dialysis compared with children with a functioning transplant and the general population can be explained as they display higher mortality rates at the youngest ages with a subsequent sharper decline in mortality and improved growth.…”

Section: Discussionmentioning

confidence: 99%

Calculating the Rate of Senescence From Mortality Data: An Analysis of Data From the ERA-EDTA Registry

Koopman¹,

Rozing²,

Kramer³

et al. 2015

GERONA

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The rate of senescence can be inferred from the acceleration by which mortality rates increase over age. Such a senescence rate is generally estimated from parameters of a mathematical model fitted to these mortality rates. However, such models have limitations and underlying assumptions. Notably, they do not fit mortality rates at young and old ages. Therefore, we developed a method to calculate senescence rates from the acceleration of mortality directly without modeling the mortality rates. We applied the different methods to age group-specific mortality data from the European Renal Association-European Dialysis and Transplant Association Registry, including patients with end-stage renal disease on dialysis, who are known to suffer from increased senescence rates (n = 302,455), and patients with a functioning kidney transplant (n = 74,490). From age 20 to 70, senescence rates were comparable when calculated with or without a model. However, when using non-modeled mortality rates, senescence rates were yielded at young and old ages that remained concealed when using modeled mortality rates. At young ages senescence rates were negative, while senescence rates declined at old ages. In conclusion, the rate of senescence can be calculated directly from non-modeled mortality rates, overcoming the disadvantages of an indirect estimation based on modeled mortality rates.

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“…The converse is also true, i.e. hypertension is common in children with chronic kidney disease [7] and present in about half of children on hemodialysis [8] or following transplantation [9]. The next most common cause of secondary hypertension is renovascular disease.…”

Section: Causes Of Hypertensionmentioning

confidence: 99%