Pediatric dialysis and renal transplantation in Kuwait over the past 11 years

Abstract

Data on end-stage renal disease (ESRD) patients and their renal replacement therapy (RRT) were collected retrospectively from the three dialysis centers, the pediatric urology unit, and the organ transplant center of Kuwait. The study period was from 1 January 1986 to 31 December 1996. A total of 61 children, 50 of whom were Kuwaiti nationals, required RRT for ESRD during those 11 years. This gave an average annual incidence rate of 18 per million Kuwaiti children. Glomerulonephritis was the most-frequent underlying disease and accounted for 44% of total cases, while pyelonephritis (including urinary tract anomalies and dysplastic kidneys) was responsible for 30%. Multisystem disease was responsible for ESRD in 7 patients (14%), 2 of whom had lupus nephritis, 2 vasculitis, 2 Henoch-Schönlein purpura, and 1 hemolytic uremic syndrome. Continuous ambulatory peritoneal dialysis and home intermittent peritoneal dialysis, using cycler machines, were not favored dialysis techniques by most parents, especially for those <6 years old. The actuarial survival on dialysis was 75%+/-7% at 12 months. Of the 8 patients who died, 7 were <6 years old. Thirty-eight patients received 46 kidney transplants, 13 of which were performed on a pre-emptive basis. The actuarial patient survivals at 12 months for those receiving first live and cadaveric kidney transplants were 90%+/-5% and 85%+/-2%, respectively, while those for grafts were 76%+/-8% and 66%+/-2%, respectively. This is the first nationwide long-term study of the incidence and etiology of pediatric ESRD in our area and the RRT in a country with adequate treatment facilities.

Twenty years’ pediatric chronic peritoneal dialysis in Uruguay: patient and technique survival

“…A CPD program with skilled and motivated dialysis staff, but lacking financial support is a dramatically frustrating situation for patients, their families and the health care staff. In regions where no pediatric RRT infrastructure is available, children are managed in adult dialysis units, which involve potential risk of RRT undercoverage for the very young, even when dialysis is fully government-funded [20]. Developing countries are a very poorly defined category, encompassing countries with a myriad of economic, epidemiologic, demographic conditions and health care systems, with a spectrum of access to RRT ranging from nil to universal [21].…”

Glomerulopathy in Kuwait: The Spectrum over the Past 7 Years

“…[5] In Kuwait, retrospective studies, have shown that GP is the possible underlying etiology for 24% of the 72 patient per million Kuwaiti nationals accepted on renal replacement therapy every year [10] and 44% of the 18 per million Kuwaiti children. [11] To examine the spectrum of GP in Kuwait, we conducted our study in a prospective manner, for a period of seven years, using the mature diagnostic facilities at Al-Amiri renal center, which covers nearly 1/2 of the care of patients with renal diseases in the state of Kuwait.…”

AsPNA

“…A total of 61 children, 50 of whom were Kuwaiti nationals, required renal replacement therapy for end-stage renal disease over a period of 11 years [100]. Glomerulonephritis (44 %) was the most frequent underlying disease, while pyelonephritis (including urinary tract anomalies and dysplastic kidneys) occurred in 30 %.…”