Survival in children requiring chronic renal replacement therapy

Chesnaye, Nicholas C.; Stralen, Karlijn J. van; Bonthuis, Marjolein; Harambat, Jérôme; Groothoff, Jaap W.; Jager, Kitty J.

doi:10.1007/s00467-017-3681-9

Cited by 45 publications

(33 citation statements)

References 109 publications

(112 reference statements)

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“…Several other reports have studied the association between key patient and treatment factors and all-cause mortality. Consistent with the findings of previous studies, we found that the youngest age group (<2 years at start of RRT) had the highest mortality [5,15,24].…”

Section: Comparison Of All-cause Mortality With Previous Studiessupporting

confidence: 92%

“…Our findings were similar to the 86% cumulative 10-year survival reported from a Canadian cohort including 843 children starting RRT between 1992 and 2007 [15]. However, McDonald and Craig reported slightly lower survival figures based on older data from the Australian and New Zealand (ANZDATA) registries collected between 1963 and 2002 [4], and the ERA/EDTA has published higher overall longterm cumulative survival figures based on recent data from Europe [24]. The variation of these survival rates can at least partly be explained by differences in study period included in the analyses.…”

Section: Comparison Of All-cause Mortality With Previous Studiessupporting

confidence: 86%

“…The variation of these survival rates can at least partly be explained by differences in study period included in the analyses. For example, data from ANZDATA showed increased survival [4] due to availability of effective treatments [24]. Several other reports have studied the association between key patient and treatment factors and all-cause mortality.…”

Section: Comparison Of All-cause Mortality With Previous Studiesmentioning

confidence: 99%

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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

et al. 2019

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Background Data on long-term outcomes in children who have received renal replacement therapy (RRT) for end-stage renal disease are limited. Methods We studied long-term survival and incidence of fatal and nonfatal cardiovascular disease (CVD) events and determinants of these outcomes in children who initiated RRT between 1961 and 2013 using data from the Scottish Renal Registry (SRR). Linkage to morbidity records was available from 1981. Results A total of 477 children of whom 55% were boys, almost 50% had congenital urinary tract disease (CAKUT), 10% received a transplant as the first mode of RRT and almost 60% were over 11 years of age at start of RRT were followed for a median of 17.8 years (interquartile range (IQR) 8.7-26.6 years). Survival was 87.3% (95% confidence interval (CI) 84.0-90.1) at 10 years and 77.6% (95% CI 73.3-81.7) at 20 years. During a median follow-up of 14.96 years (IQR 7.1-22.9), 20.9% of the 381 patients with morbidity data available had an incident of CVD event. Age < 2 years at start of RRT, receiving dialysis rather than a kidney transplant and primary renal disease (PRD) other than CAKUT or glomerulonephritis (GN), were associated with a higher risk of all-cause mortality. Male sex, receiving dialysis rather than a kidney transplant and PRD other than CAKUT or GN, was associated with a higher risk of CVD incidence. Conclusions Mortality and CVD incidence among children receiving RRT are high. PRD and RRT modality were associated with increased risk of both all-cause mortality and CVD incidence.

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Section: Comparison Of All-cause Mortality With Previous Studiessupporting

confidence: 92%

Section: Comparison Of All-cause Mortality With Previous Studiessupporting

confidence: 86%

Section: Comparison Of All-cause Mortality With Previous Studiesmentioning

confidence: 99%

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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

et al. 2019

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“…The survival of kidney grafts has improved considerably in recent years, due to advances in surgical techniques and in immunosuppression protocols 50,51 . Clinical acute rejection was diagnosed in 7% of the children, a rejection rate that is comparable to that from other studies 2 .…”

Section: Discussionmentioning

confidence: 95%

Association between 25(OH) vitamin D and graft survival in renal transplanted children

Mosca

Lion‐Lambert

Bienaimé

et al. 2020

Pediatric Transplantation

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Background: In children, vitamin D deficiency is common after renal transplantation. Besides promoting bone and muscle development, vitamin D has immunomodulatory effects, which could protect kidney allografts. The purpose of this study was to assess the association between vitamin D status and the occurrence of renal rejection. Methods: We studied a retrospective cohort of 123 children, who were transplanted at a single institution between September 2008 and April 2019. Patients did not receive vitamin D supplementation systematically. In addition, factors influencing vitamin D status were analyzed using univariate and multivariate analyses. Results: Median 25-hydroxy-vitamin D (25-OH-D) concentration was close to reference values at the time of transplantation (30 ng/mL (min-max 5-100)), but rapidly decreased within the first 3 months to 19 ng/mL (min-max 3-91) (P < .001). The overall acute rejection rate was 7%. The clinical rejection rate (5% vs 9%), subclinical rejection (12% vs 36%), and borderline changes (21% vs 28%) were not statistically different during the follow-up between the 3-month 25-OH-D < 20 ng/mL and 3-month 25-OH-D > 20 ng/mL groups. There was a correlation between the 25-OH-D levels and PTH concentration at 3 months (r = −.2491, P = .01), but no correlation between the 3-month 25-OH-D and the season of the year (F = 0.19, P = .90; F = 1.34, P = .27, respectively). Multivariate analyses revealed that age and mGFR at 3 months, were independent predictors of mGFR at 12 months. Conclusion: Our data show that vitamin D deficiency can develop rapidly after transplantation; vitamin D levels at 3 months are not associated with lower mGFR or a higher rejection rate at 1 year in children as opposed to adult recipients.

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“…Most countries report information from pediatric centers only. As older children (15)(16)(17)(18)(19) years of age) may be treated in adult centers, they might not be included in the ESPN/ERA-EDTA Registry, possibly leading to an underestimation of incidence and prevalence figures. Therefore, for this study, we included data of patients initiating KRT < 15 years of age from the 22 countries contributing with data on all treatment modalities for the entire period from January 1, 2007, to December 31, 2016 ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

et al. 2021

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Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

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Survival in children requiring chronic renal replacement therapy

Cited by 45 publications

References 109 publications

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

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

Association between 25(OH) vitamin D and graft survival in renal transplanted children

Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

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