Top

Published in:

01-01-2004 | Original Article

A multicenter experience on patient and technique survival in children on chronic dialysis

Authors: Enrico Verrina, Alberto Edefonti, Bruno Gianoglio, Stefano Rinaldi, Palma Sorino, Graziella Zacchello, Giancarlo Lavoratti, Silvio Maringhini, Carmine Pecoraro, Maria Grazia Calevo, Laura Turrini Dertenois, Francesco Perfumo

Published in: Pediatric Nephrology | Issue 1/2004

Abstract

In this study we compared patient and technique survival of 163 new hemodialysis (HD) patients (age 11.4±3.1 years) and 295 peritoneal dialysis patients (7.7±4.8 years. P< 0.001), treated in 23 dialysis centers participating in the Italian Registry of Pediatric Chronic Peritoneal Dialysis (CPD) during the years 1989–2000. Three HD (1.8%) and 17 CPD (5.8%) patients died; the overall average death rate was 9.8/1,000 patient-years in HD and 29.8/1,000 patient-years in CPD patients. No statistically significant difference in patient survival between CPD and HD was found, while the survival of 102 CPD children younger than 5 years at the start of dialysis was lower (P=0.0001) than that of 193 CPD and 160 HD patients aged 5–15 years. We registered 12 modality failures among HD (7.4%) patients and 44 among CPD (14.9%) patients. The main causes were vascular access failure and patient choice in HD, and infection in CPD patients. Technique survival was lower (P=0.007) in CPD than in HD patients; a statistically significant difference (P=0.01) was also observed between both the 0- to 5- and the 5- to 15-year-old CPD patients and the HD patients aged 5–15 years. Logistic regression analysis confirmed age at initiation of dialysis to be a predictor of patient death (P=0.0001) in the whole patient population, and of technique failure in HD (P=0.006) but not in CPD patients (P=0.16).

Feld LG, Stablein D, Fivush B, Harmon W, Tejani A (1997) Renal transplantation in children from 1987–1996: the 1996 annual report of the North American Pediatric Transplant Cooperative Study. Pediatr Transplant 1:146–162PubMed

Alexander SR (1999) Pediatric end-stage renal diseases. Am J Kidney Dis 34:S102–S113PubMed

Neu AM, Ho PL, McDonald RA, Warady BA (2002) Chronic dialysis in children and adolescents. The 2001 NAPRTCS Annual Report. Pediatr Nephrol 17:656–663

Vats AN, Donaldson L, Fine RN, Chavers BM (2000) Pretransplant dialysis status and outcome of renal transplantation in North American children: a NAPRTCS study. Transplantation 69:1414–1419PubMed

Fenton SSA, Schaubel DE, Desmeules M, Morison HI, Mao Y, Copleston P, Jeffery JR, Kiellstrand CM (1997) Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Dis 30:334–342PubMed

Maiorca R, Cancarini GC (2000) Outcome with peritoneal dialysis compared to haemodialysis. In: Gokal R, Krediet RT, Nolph KD (eds) Textbook of peritoneal dialysis, 2nd edn. Khewer, Dordrecht, The Netherlands, pp 755–783

Potter DE, San Luis E, Wipfler JE, Portale AA (1986) Comparison of continuous ambulatory peritoneal dialysis and hemodialysis in children. Kidney Int 30:S11–S14

Verrina E, Perfumo F, Zacchello G, Sorino P, Edefonti A, Bassi S, Calevo MG, Caringella DL, Cattarelli D, Lavoratti G, Consalvo G, Andreetta B, Rinaldi S, Longo L, Gusmano R (1996) Comparison of patient hospitalization in chronic peritoneal dialysis and hemodialysis: a pediatric multicenter study. Perit Dial Int 16 [Suppl 1]:S574–S577

Brem AS, Lambert C, Hill C, Kitsen J, Shemin DG (2001) Clinical morbidity in pediatric dialysis patients: data from the Network 1 Clinical Indicators Project. Pediatr Nephrol 16:854–857PubMed

10.

Schärer K, Reiss V, Mehls O, Gretz N, Mohring K, Muller-Wiefel DE, Wingen A (1993) Changing pattern of chronic renal failure and renal replacement therapy in children and adolescents: a 20 year single centre study. Eur J Pediatr 152:166–171PubMed

11.

Litwin M, Grenda R, Rokurat S, Abnauba M, Latoszynska J, Jobs K, Boguszewska A, Waver BZT (2001) Patient survival and causes of death on hemodialysis and peritoneal dialysis—single-center study. Pediatr Nephrol 16:996–1001CrossRefPubMed

12.

Verrina E, Andreetta B, Bassi S, Bonaudo R, Caringella DA, Castellani A, Cavalli L, Edefonti A, Lavoratti G, Longo L, Pela I, Penza R, Perfumo F, Petrucci V, Picca M, Ragaiolo M, Rinaldi S, Rizzoni G, Sorino P, Viglino G, Zacchello G, Gusmano R (1992) Chronic peritoneal dialysis in pediatrics: experience of a national registry. Pediatr Nephrol 6:78–81PubMed

13.

Verrina E, Zacchello G, Edefonti A, Sorino P, Rinaldi S, Gianoglio B, Lavoratti G, Maringhini S, Perfumo F (2001) A multicenter survey on automated peritoneal dialysis prescription in children. Adv Perit Dial 17:264–268PubMed

14.

Hattori S, Yosioka K, Honda M, Ito H (2002) The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol 17:456–461CrossRefPubMed

15.

Lerner GR, Warady BA, Sullivan EK, Alexander SR (1999) Chronic dialysis in children and adolescents. The 1996 Annual Report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Nephrol 13:404–417PubMed

16.

Honda M (1999) The 1997 report of the Japanese National Registry data on pediatric peritoneal dialysis patients. Perit Dial Int 19: S473–S478PubMed

17.

Schaefer F, Klaus G, Müller-Wiefel DE, Mehls O (1999) Current practice of peritoneal dialysis in children: results of a longitudinal survey. Perit Dial Int 19:S445–S449PubMed

18.

Wood EG, Hand M, Briscol DM, Donaldson LA, Yiu V, Harley FL, Warady BA, Ellis EN (2001) Risk factors for mortality in infants and young children on dialysis. Am J Kidney Dis 37:573–579PubMed

19.

Chavers BM, Li S, Collins AJ, Herzog CA (2002) Cardiovascular disease in pediatric chronic dialysis patients. Kidney Int 62:648–653CrossRefPubMed

20.

Warady BA, Sullivan EK, Alexander SR (1996) Lessons from the peritoneal dialysis patient database: a report of the North American Pediatric Renal Transplant Cooperative Study. Kidney Int 49:S68–S71

21.

Schaefer F, Klaus G, Müller-Wiefel DE, Mehls O (1999) Intermittent versus continuous intraperitoneal glycopeptide/ceftazidime treatment in children with peritoneal dialysis-associated peritonitis. J Am Soc Nephrol 10:136–145PubMed

22.

Verrina E, Perfumo F, Calevo MG, Rinaldi S, Sorino P, Andreetta B, Bonaudo R, Lavoratti G, Edefonti A (1999) The Italian Chronic Peritoneal Dialysis Registry. Perit Dial Int 19:S479–S483PubMed

23.

Furth SL, Donaldson LA, Sullivan EK, Watkins SL (2000) Peritoneal dialysis catheter infections and peritonitis in children: a report from the North American Pediatric Renal Transplant Cooperative Study. Pediatr Nephrol 15:179–182CrossRefPubMed

24.

Warady BA (2000) Sclerosing encapsulating peritonitis: what approach should be taken with children. Perit Dial Int 20:390–391PubMed

25.

Watson AR, Gartland C (2001) Guidelines by an Ad Hoc Committee for elective chronic peritoneal dialysis in pediatric patients. Perit Dial Int 21:240–244PubMed

26.

Gulati S, Stephens D, Balfe JA, Suker D, Harvey E, Balfe JW (2001) Children with hypoalbuminemia on continuous peritoneal dialysis are at risk of technique failure. Kidney Int 59:2361–2367CrossRefPubMed

27.

Warady BA, Schaefer F, Holloway M, Alexander SR, Kandert M, Piraino B, Salusky I, Traneus A, Divino J, Honda M, Mujais S, Verrina E (1999) Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis. Perit Dial Int 20:610–624

28.

Verrina E, Honda M, Warady BA, Piraino B (2000) Prevention of peritonitis in children on peritoneal dialysis. Perit Dial Int 20:625–630PubMed

29.

Churchill DN, Taylor DW, Keshaviah PR, Thorpe KE, Beecroft ML (1996) Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcomes. J Am Soc Nephrol 7:198–207PubMed

30.

Bargman JM, Thorpe KE, Churchill DN (2001) Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: a reanalysis of the CANUSA study. J Am Soc Nephrol 12:2158–2162PubMed

31.

Paniagua R, Amato D, Vonesh E, Correa-Rotter R, Ramos A Moran J, Mujais S (2002) Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol 13:1307–1320

32.

Rees L (2002) Management of the infant with end-stage renal failure. Nephrol Dial Transplant 17:1564–1567CrossRefPubMed

Title: A multicenter experience on patient and technique survival in children on chronic dialysis
Authors: Enrico Verrina
Alberto Edefonti
Bruno Gianoglio
Stefano Rinaldi
Palma Sorino
Graziella Zacchello
Giancarlo Lavoratti
Silvio Maringhini
Carmine Pecoraro
Maria Grazia Calevo
Laura Turrini Dertenois
Francesco Perfumo
Publication date: 01-01-2004
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 1/2004
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-003-1270-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A multicenter experience on patient and technique survival in children on chronic dialysis

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2004

Parathyroid hormone levels in pubertal uremic adolescents treated with growth hormone

Dent disease with compound heterozygous mutations leading to severe chronic renal failure in a female patient

Adequacy of dialysis in children: does small solute clearance really matter?

Rapid decline of anti-pneumococcal antibody levels in nephrotic children

Efficacy of losartan in the treatment of erythrocytosis in a young adult with CRF

Acute renal failure in a patient with phosphofructokinase deficiency