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Pediatric Nephrology
Published in: Pediatric Nephrology 4/2020

Open Access 01-04-2020 | Peritoneal Dialysis | Original Article

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

Authors: Dinara B. Galiyeva, Caroline A. Jackson, Sarah H. Wild, Susan Burns, David Hughes, Jamie P. Traynor, Wendy Metcalfe, Nynke Halbesma

Published in: Pediatric Nephrology | Issue 4/2020

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Abstract

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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Metadata
Title
Long-term all-cause mortality and cardiovascular outcomes in Scottish children after initiation of renal replacement therapy: a national cohort study
Authors
Dinara B. Galiyeva
Caroline A. Jackson
Sarah H. Wild
Susan Burns
David Hughes
Jamie P. Traynor
Wendy Metcalfe
Nynke Halbesma
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 4/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04430-4

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