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01-07-2019 | Peritoneal Dialysis | Original Article

Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry

Authors: Katrin Lübbe, Eva Nüsken, Katherine Rascher, Gero von Gersdorff, Heyke Cramer, Christina Samel, Claudia Barth, Dieter Bach, Lutz T. Weber, Jörg Dötsch

Published in: Pediatric Nephrology | Issue 7/2019

Abstract

Background

Paediatric dialysis patients still suffer from high morbidity rates. To improve this, quality assurance programs like the German QiNKid (Quality in Nephrology for Children)-Registry have been developed. In our study, the significance of underlying renal disease on a range of clinical and laboratory parameters impacting morbidity and mortality was analysed. Our aim was to evaluate whether or not disease-specific dialysis strategies should be considered in planning dialysis for a patient.

Methods

Inclusion criteria were defined as follows: (1) CAKUT (congenital anomalies of the kidney and urinary tract) or glomerular disease patient, (2) < 18 years of age, (3) haemodialysis or peritoneal dialysis patient. Only measurements obtained from day 90 to 365 after the date of the first dialysis in the registry were analysed. Laboratory (serum albumin, haemoglobin, ferritin, calcium, phosphate, parathyroid hormone) and clinical parameters (height, blood pressure) were analysed using mixed effects models accounting for the correlation of repeated measures in individual patients.

Results

The study cohort comprised n = 167 CAKUT and n = 55 glomerular disease patients. Glomerular disease patients had significantly higher odds of hypoalbuminemia (OR 13.90, 95% CI 1.35–159.99; p = 0.0274), anaemia (OR 3.31, 95% CI 1.22–9.13; p = 0.0197), hyperphosphatemia (OR 9.69, 95% CI 2.65–37.26; p = 0.0006) and diastolic hypertension (OR 3.38, 95% CI 1.20–9.79; p = 0.0212).

Conclusions

Glomerular disease patients might require more intensive dialysis regimens. The evaluation of hydration status should be given more attention, since conditions differing between the cohorts can be linked to overhydration. The QiNKid-Registry allows monitoring of the quality of paediatric dialysis in a nationwide cohort.

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Title: Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry
Authors: Katrin Lübbe
Eva Nüsken
Katherine Rascher
Gero von Gersdorff
Heyke Cramer
Christina Samel
Claudia Barth
Dieter Bach
Lutz T. Weber
Jörg Dötsch
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Peritoneal Dialysis
Hypertension
Hypertension
Published in: Pediatric Nephrology / Issue 7/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04218-6

At a glance: The STEP trials

Springer Medicine

Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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