Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis
Background The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. Study Design Cohort study. Setting & Participants Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or...
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| Veröffentlicht in: | American journal of kidney diseases 2017-05, Vol.69 (5), p.617-625 |
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| creator | Vidal, Enrico, MD, PhD van Stralen, Karlijn J., PhD Chesnaye, Nicholas C., MSc Bonthuis, Marjolein, PhD Holmberg, Christer, MD Zurowska, Aleksandra, MD Trivelli, Antonella, MD Da Silva, José Eduardo Esteves, MD Herthelius, Maria, MD Adams, Brigitte, MD Bjerre, Anna, MD, PhD Jankauskiene, Augustina, MD, PhD Miteva, Polina, MD Emirova, Khadizha, MD Bayazit, Aysun K., MD Mache, Christoph J., MD Sánchez-Moreno, Ana, MD Harambat, Jérôme, MD, PhD Groothoff, Jaap W., MD, PhD Jager, Kitty J., MD, PhD Schaefer, Franz, MD Verrina, Enrico, MD |
| description | Background The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. Study Design Cohort study. Setting & Participants Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or younger who initiated dialysis therapy in 1991 to 2013. Factor Type of dialysis modality. Outcomes & Measurements Differences between infants treated with peritoneal dialysis (PD) or hemodialysis (HD) in patient survival, technique survival, and access to kidney transplantation were examined using Cox regression analysis while adjusting for age at dialysis therapy initiation, sex, underlying kidney disease, and country of residence. Results 917 infants initiated dialysis therapy on PD, and 146, on HD. Median age at dialysis therapy initiation was 4.5 (IQR, 0.7-7.9) months, and median body weight was 5.7 (IQR, 3.7-7.5) kg. Although the groups were homogeneous regarding age and sex, infants treated with PD more often had congenital anomalies of the kidney and urinary tract (CAKUT; 48% vs 27%), whereas those on HD therapy more frequently had metabolic disorders (12% vs 4%). Risk factors for death were younger age at dialysis therapy initiation (HR per each 1-month later initiation, 0.95; 95% CI, 0.90-0.97) and non-CAKUT cause of chronic kidney failure (HR, 1.49; 95% CI, 1.08-2.04). Mortality risk and likelihood of transplantation were equal in PD and HD patients, whereas HD patients had a higher risk for changing dialysis treatment (adjusted HR, 1.64; 95% CI, 1.17-2.31). Limitations Inability to control for unmeasured confounders not included in the Registry database and missing data (ie, comorbid conditions). Low statistical power because of relatively small number of participants. Conclusions Despite a widespread preconception that HD should be reserved for cases in which PD is not feasible, in Europe, we found 1 in 8 infants in need of maintenance dialysis to be initiated on HD therapy. Patient characteristics at dialysis therapy initiation, prospective survival, and time to transplantation were very similar for infants initiated on PD or HD therapy. |
| doi_str_mv | 10.1053/j.ajkd.2016.09.024 |
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| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_500471</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0272638616305960</els_id><sourcerecordid>1852665339</sourcerecordid><originalsourceid>FETCH-LOGICAL-c629t-becd0dc1b5634549c994b48663093ed4587ca735e2fd5e3eedcae570be43d4e3</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhS0EotPCC7BAWbJJcPyXGCGkqhRaqagIumBnOfYNciaxp3YCmrfH0QyzYMHKlv2do6tzLkKvalzVmNO3Q6WHra0IrkWFZYUJe4I2NSe0FC1tn6INJg0pBW3FGTpPacAYSyrEc3RGGsm5JGyDftz6Xvs5Fd_gcXHR-Z_FF-38DF57A8VHp8d9culdcb_MJkyQitAXNzAFe_wptLfFV4huDh70eFK8QM96PSZ4eTwv0MOn64erm_Lu_vPt1eVdaQSRc9mBsdiauuOCMs6kkZJ1rBWC5lnBMt42RjeUA-ktBwpgjQbe4A4YtQzoBSoPtuk37JZO7aKbdNyroJ06Pm3zDRTHmDV15t8c-F0MjwukWU0uGRhH7SEsSdUtJ0JwSmVGyQE1MaQUoT-Z11itBahBrQWotQCFpcoFZNHro__STWBPkr-JZ-D9AYAcyi8HUSXjIGdtXQQzKxvc__0__CM3o_PO6HELe0hDWKLPcataJaKw-r6uwLoBdQ6US4HpH6TOrYI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1852665339</pqid></control><display><type>article</type><title>Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Vidal, Enrico, MD, PhD ; van Stralen, Karlijn J., PhD ; Chesnaye, Nicholas C., MSc ; Bonthuis, Marjolein, PhD ; Holmberg, Christer, MD ; Zurowska, Aleksandra, MD ; Trivelli, Antonella, MD ; Da Silva, José Eduardo Esteves, MD ; Herthelius, Maria, MD ; Adams, Brigitte, MD ; Bjerre, Anna, MD, PhD ; Jankauskiene, Augustina, MD, PhD ; Miteva, Polina, MD ; Emirova, Khadizha, MD ; Bayazit, Aysun K., MD ; Mache, Christoph J., MD ; Sánchez-Moreno, Ana, MD ; Harambat, Jérôme, MD, PhD ; Groothoff, Jaap W., MD, PhD ; Jager, Kitty J., MD, PhD ; Schaefer, Franz, MD ; Verrina, Enrico, MD</creator><creatorcontrib>Vidal, Enrico, MD, PhD ; van Stralen, Karlijn J., PhD ; Chesnaye, Nicholas C., MSc ; Bonthuis, Marjolein, PhD ; Holmberg, Christer, MD ; Zurowska, Aleksandra, MD ; Trivelli, Antonella, MD ; Da Silva, José Eduardo Esteves, MD ; Herthelius, Maria, MD ; Adams, Brigitte, MD ; Bjerre, Anna, MD, PhD ; Jankauskiene, Augustina, MD, PhD ; Miteva, Polina, MD ; Emirova, Khadizha, MD ; Bayazit, Aysun K., MD ; Mache, Christoph J., MD ; Sánchez-Moreno, Ana, MD ; Harambat, Jérôme, MD, PhD ; Groothoff, Jaap W., MD, PhD ; Jager, Kitty J., MD, PhD ; Schaefer, Franz, MD ; Verrina, Enrico, MD ; Spanish Pediatric Registry ; ESPN/ERA-EDTA Registry</creatorcontrib><description>Background The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. Study Design Cohort study. Setting & Participants Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or younger who initiated dialysis therapy in 1991 to 2013. Factor Type of dialysis modality. Outcomes & Measurements Differences between infants treated with peritoneal dialysis (PD) or hemodialysis (HD) in patient survival, technique survival, and access to kidney transplantation were examined using Cox regression analysis while adjusting for age at dialysis therapy initiation, sex, underlying kidney disease, and country of residence. Results 917 infants initiated dialysis therapy on PD, and 146, on HD. Median age at dialysis therapy initiation was 4.5 (IQR, 0.7-7.9) months, and median body weight was 5.7 (IQR, 3.7-7.5) kg. Although the groups were homogeneous regarding age and sex, infants treated with PD more often had congenital anomalies of the kidney and urinary tract (CAKUT; 48% vs 27%), whereas those on HD therapy more frequently had metabolic disorders (12% vs 4%). Risk factors for death were younger age at dialysis therapy initiation (HR per each 1-month later initiation, 0.95; 95% CI, 0.90-0.97) and non-CAKUT cause of chronic kidney failure (HR, 1.49; 95% CI, 1.08-2.04). Mortality risk and likelihood of transplantation were equal in PD and HD patients, whereas HD patients had a higher risk for changing dialysis treatment (adjusted HR, 1.64; 95% CI, 1.17-2.31). Limitations Inability to control for unmeasured confounders not included in the Registry database and missing data (ie, comorbid conditions). Low statistical power because of relatively small number of participants. Conclusions Despite a widespread preconception that HD should be reserved for cases in which PD is not feasible, in Europe, we found 1 in 8 infants in need of maintenance dialysis to be initiated on HD therapy. Patient characteristics at dialysis therapy initiation, prospective survival, and time to transplantation were very similar for infants initiated on PD or HD therapy.</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2016.09.024</identifier><identifier>PMID: 27955924</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Cause of Death ; end-stage renal disease (ESRD) ; ESPN/ERA-EDTA Registry ; Europe ; European Registery for Children on Renal Replacement Therapy ; Female ; Glomerulonephritis - complications ; Health Services Accessibility ; hemodialysis (HD) ; Hemolytic-Uremic Syndrome - complications ; Humans ; Infant ; Infant, Newborn ; Ischemia - complications ; Kidney Diseases, Cystic - complications ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - therapy ; Kidney Transplantation - statistics & numerical data ; maintenance dialysis ; Male ; Metabolic Diseases - complications ; Mortality ; Nephrology ; outcome ; Pediatric nephrology ; peritoneal dialysis (PD) ; Peritoneal Dialysis - methods ; Proportional Hazards Models ; Registries ; Renal Dialysis - methods ; renal replacement therapy (RRT) ; Retrospective Studies ; RRT modality ; survival ; Survival Rate ; Time Factors ; Treatment Outcome ; Urogenital Abnormalities - complications ; Vasculitis - complications</subject><ispartof>American journal of kidney diseases, 2017-05, Vol.69 (5), p.617-625</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2016 National Kidney Foundation, Inc.</rights><rights>Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c629t-becd0dc1b5634549c994b48663093ed4587ca735e2fd5e3eedcae570be43d4e3</citedby><cites>FETCH-LOGICAL-c629t-becd0dc1b5634549c994b48663093ed4587ca735e2fd5e3eedcae570be43d4e3</cites><orcidid>0000-0003-3963-0803</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2016.09.024$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,777,781,882,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27955924$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:135655162$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Vidal, Enrico, MD, PhD</creatorcontrib><creatorcontrib>van Stralen, Karlijn J., PhD</creatorcontrib><creatorcontrib>Chesnaye, Nicholas C., MSc</creatorcontrib><creatorcontrib>Bonthuis, Marjolein, PhD</creatorcontrib><creatorcontrib>Holmberg, Christer, MD</creatorcontrib><creatorcontrib>Zurowska, Aleksandra, MD</creatorcontrib><creatorcontrib>Trivelli, Antonella, MD</creatorcontrib><creatorcontrib>Da Silva, José Eduardo Esteves, MD</creatorcontrib><creatorcontrib>Herthelius, Maria, MD</creatorcontrib><creatorcontrib>Adams, Brigitte, MD</creatorcontrib><creatorcontrib>Bjerre, Anna, MD, PhD</creatorcontrib><creatorcontrib>Jankauskiene, Augustina, MD, PhD</creatorcontrib><creatorcontrib>Miteva, Polina, MD</creatorcontrib><creatorcontrib>Emirova, Khadizha, MD</creatorcontrib><creatorcontrib>Bayazit, Aysun K., MD</creatorcontrib><creatorcontrib>Mache, Christoph J., MD</creatorcontrib><creatorcontrib>Sánchez-Moreno, Ana, MD</creatorcontrib><creatorcontrib>Harambat, Jérôme, MD, PhD</creatorcontrib><creatorcontrib>Groothoff, Jaap W., MD, PhD</creatorcontrib><creatorcontrib>Jager, Kitty J., MD, PhD</creatorcontrib><creatorcontrib>Schaefer, Franz, MD</creatorcontrib><creatorcontrib>Verrina, Enrico, MD</creatorcontrib><creatorcontrib>Spanish Pediatric Registry</creatorcontrib><creatorcontrib>ESPN/ERA-EDTA Registry</creatorcontrib><title>Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Background The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. Study Design Cohort study. Setting & Participants Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or younger who initiated dialysis therapy in 1991 to 2013. Factor Type of dialysis modality. Outcomes & Measurements Differences between infants treated with peritoneal dialysis (PD) or hemodialysis (HD) in patient survival, technique survival, and access to kidney transplantation were examined using Cox regression analysis while adjusting for age at dialysis therapy initiation, sex, underlying kidney disease, and country of residence. Results 917 infants initiated dialysis therapy on PD, and 146, on HD. Median age at dialysis therapy initiation was 4.5 (IQR, 0.7-7.9) months, and median body weight was 5.7 (IQR, 3.7-7.5) kg. Although the groups were homogeneous regarding age and sex, infants treated with PD more often had congenital anomalies of the kidney and urinary tract (CAKUT; 48% vs 27%), whereas those on HD therapy more frequently had metabolic disorders (12% vs 4%). Risk factors for death were younger age at dialysis therapy initiation (HR per each 1-month later initiation, 0.95; 95% CI, 0.90-0.97) and non-CAKUT cause of chronic kidney failure (HR, 1.49; 95% CI, 1.08-2.04). Mortality risk and likelihood of transplantation were equal in PD and HD patients, whereas HD patients had a higher risk for changing dialysis treatment (adjusted HR, 1.64; 95% CI, 1.17-2.31). Limitations Inability to control for unmeasured confounders not included in the Registry database and missing data (ie, comorbid conditions). Low statistical power because of relatively small number of participants. Conclusions Despite a widespread preconception that HD should be reserved for cases in which PD is not feasible, in Europe, we found 1 in 8 infants in need of maintenance dialysis to be initiated on HD therapy. Patient characteristics at dialysis therapy initiation, prospective survival, and time to transplantation were very similar for infants initiated on PD or HD therapy.</description><subject>Age Factors</subject><subject>Cause of Death</subject><subject>end-stage renal disease (ESRD)</subject><subject>ESPN/ERA-EDTA Registry</subject><subject>Europe</subject><subject>European Registery for Children on Renal Replacement Therapy</subject><subject>Female</subject><subject>Glomerulonephritis - complications</subject><subject>Health Services Accessibility</subject><subject>hemodialysis (HD)</subject><subject>Hemolytic-Uremic Syndrome - complications</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Ischemia - complications</subject><subject>Kidney Diseases, Cystic - complications</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidney Transplantation - statistics & numerical data</subject><subject>maintenance dialysis</subject><subject>Male</subject><subject>Metabolic Diseases - complications</subject><subject>Mortality</subject><subject>Nephrology</subject><subject>outcome</subject><subject>Pediatric nephrology</subject><subject>peritoneal dialysis (PD)</subject><subject>Peritoneal Dialysis - methods</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Renal Dialysis - methods</subject><subject>renal replacement therapy (RRT)</subject><subject>Retrospective Studies</subject><subject>RRT modality</subject><subject>survival</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Urogenital Abnormalities - complications</subject><subject>Vasculitis - complications</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhS0EotPCC7BAWbJJcPyXGCGkqhRaqagIumBnOfYNciaxp3YCmrfH0QyzYMHKlv2do6tzLkKvalzVmNO3Q6WHra0IrkWFZYUJe4I2NSe0FC1tn6INJg0pBW3FGTpPacAYSyrEc3RGGsm5JGyDftz6Xvs5Fd_gcXHR-Z_FF-38DF57A8VHp8d9culdcb_MJkyQitAXNzAFe_wptLfFV4huDh70eFK8QM96PSZ4eTwv0MOn64erm_Lu_vPt1eVdaQSRc9mBsdiauuOCMs6kkZJ1rBWC5lnBMt42RjeUA-ktBwpgjQbe4A4YtQzoBSoPtuk37JZO7aKbdNyroJ06Pm3zDRTHmDV15t8c-F0MjwukWU0uGRhH7SEsSdUtJ0JwSmVGyQE1MaQUoT-Z11itBahBrQWotQCFpcoFZNHro__STWBPkr-JZ-D9AYAcyi8HUSXjIGdtXQQzKxvc__0__CM3o_PO6HELe0hDWKLPcataJaKw-r6uwLoBdQ6US4HpH6TOrYI</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Vidal, Enrico, MD, PhD</creator><creator>van Stralen, Karlijn J., PhD</creator><creator>Chesnaye, Nicholas C., MSc</creator><creator>Bonthuis, Marjolein, PhD</creator><creator>Holmberg, Christer, MD</creator><creator>Zurowska, Aleksandra, MD</creator><creator>Trivelli, Antonella, MD</creator><creator>Da Silva, José Eduardo Esteves, MD</creator><creator>Herthelius, Maria, MD</creator><creator>Adams, Brigitte, MD</creator><creator>Bjerre, Anna, MD, PhD</creator><creator>Jankauskiene, Augustina, MD, PhD</creator><creator>Miteva, Polina, MD</creator><creator>Emirova, Khadizha, MD</creator><creator>Bayazit, Aysun K., MD</creator><creator>Mache, Christoph J., MD</creator><creator>Sánchez-Moreno, Ana, MD</creator><creator>Harambat, Jérôme, MD, PhD</creator><creator>Groothoff, Jaap W., MD, PhD</creator><creator>Jager, Kitty J., MD, PhD</creator><creator>Schaefer, Franz, MD</creator><creator>Verrina, Enrico, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><orcidid>https://orcid.org/0000-0003-3963-0803</orcidid></search><sort><creationdate>20170501</creationdate><title>Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis</title><author>Vidal, Enrico, MD, PhD ; van Stralen, Karlijn J., PhD ; Chesnaye, Nicholas C., MSc ; Bonthuis, Marjolein, PhD ; Holmberg, Christer, MD ; Zurowska, Aleksandra, MD ; Trivelli, Antonella, MD ; Da Silva, José Eduardo Esteves, MD ; Herthelius, Maria, MD ; Adams, Brigitte, MD ; Bjerre, Anna, MD, PhD ; Jankauskiene, Augustina, MD, PhD ; Miteva, Polina, MD ; Emirova, Khadizha, MD ; Bayazit, Aysun K., MD ; Mache, Christoph J., MD ; Sánchez-Moreno, Ana, MD ; Harambat, Jérôme, MD, PhD ; Groothoff, Jaap W., MD, PhD ; Jager, Kitty J., MD, PhD ; Schaefer, Franz, MD ; Verrina, Enrico, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c629t-becd0dc1b5634549c994b48663093ed4587ca735e2fd5e3eedcae570be43d4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>Cause of Death</topic><topic>end-stage renal disease (ESRD)</topic><topic>ESPN/ERA-EDTA Registry</topic><topic>Europe</topic><topic>European Registery for Children on Renal Replacement Therapy</topic><topic>Female</topic><topic>Glomerulonephritis - complications</topic><topic>Health Services Accessibility</topic><topic>hemodialysis (HD)</topic><topic>Hemolytic-Uremic Syndrome - complications</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Ischemia - complications</topic><topic>Kidney Diseases, Cystic - complications</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Kidney Transplantation - statistics & numerical data</topic><topic>maintenance dialysis</topic><topic>Male</topic><topic>Metabolic Diseases - complications</topic><topic>Mortality</topic><topic>Nephrology</topic><topic>outcome</topic><topic>Pediatric nephrology</topic><topic>peritoneal dialysis (PD)</topic><topic>Peritoneal Dialysis - methods</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Renal Dialysis - methods</topic><topic>renal replacement therapy (RRT)</topic><topic>Retrospective Studies</topic><topic>RRT modality</topic><topic>survival</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Urogenital Abnormalities - complications</topic><topic>Vasculitis - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vidal, Enrico, MD, PhD</creatorcontrib><creatorcontrib>van Stralen, Karlijn J., PhD</creatorcontrib><creatorcontrib>Chesnaye, Nicholas C., MSc</creatorcontrib><creatorcontrib>Bonthuis, Marjolein, PhD</creatorcontrib><creatorcontrib>Holmberg, Christer, MD</creatorcontrib><creatorcontrib>Zurowska, Aleksandra, MD</creatorcontrib><creatorcontrib>Trivelli, Antonella, MD</creatorcontrib><creatorcontrib>Da Silva, José Eduardo Esteves, MD</creatorcontrib><creatorcontrib>Herthelius, Maria, MD</creatorcontrib><creatorcontrib>Adams, Brigitte, MD</creatorcontrib><creatorcontrib>Bjerre, Anna, MD, PhD</creatorcontrib><creatorcontrib>Jankauskiene, Augustina, MD, PhD</creatorcontrib><creatorcontrib>Miteva, Polina, MD</creatorcontrib><creatorcontrib>Emirova, Khadizha, MD</creatorcontrib><creatorcontrib>Bayazit, Aysun K., MD</creatorcontrib><creatorcontrib>Mache, Christoph J., MD</creatorcontrib><creatorcontrib>Sánchez-Moreno, Ana, MD</creatorcontrib><creatorcontrib>Harambat, Jérôme, MD, PhD</creatorcontrib><creatorcontrib>Groothoff, Jaap W., MD, PhD</creatorcontrib><creatorcontrib>Jager, Kitty J., MD, PhD</creatorcontrib><creatorcontrib>Schaefer, Franz, MD</creatorcontrib><creatorcontrib>Verrina, Enrico, MD</creatorcontrib><creatorcontrib>Spanish Pediatric Registry</creatorcontrib><creatorcontrib>ESPN/ERA-EDTA Registry</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vidal, Enrico, MD, PhD</au><au>van Stralen, Karlijn J., PhD</au><au>Chesnaye, Nicholas C., MSc</au><au>Bonthuis, Marjolein, PhD</au><au>Holmberg, Christer, MD</au><au>Zurowska, Aleksandra, MD</au><au>Trivelli, Antonella, MD</au><au>Da Silva, José Eduardo Esteves, MD</au><au>Herthelius, Maria, MD</au><au>Adams, Brigitte, MD</au><au>Bjerre, Anna, MD, PhD</au><au>Jankauskiene, Augustina, MD, PhD</au><au>Miteva, Polina, MD</au><au>Emirova, Khadizha, MD</au><au>Bayazit, Aysun K., MD</au><au>Mache, Christoph J., MD</au><au>Sánchez-Moreno, Ana, MD</au><au>Harambat, Jérôme, MD, PhD</au><au>Groothoff, Jaap W., MD, PhD</au><au>Jager, Kitty J., MD, PhD</au><au>Schaefer, Franz, MD</au><au>Verrina, Enrico, MD</au><aucorp>Spanish Pediatric Registry</aucorp><aucorp>ESPN/ERA-EDTA Registry</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>69</volume><issue>5</issue><spage>617</spage><epage>625</epage><pages>617-625</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Background The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. Study Design Cohort study. Setting & Participants Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or younger who initiated dialysis therapy in 1991 to 2013. Factor Type of dialysis modality. Outcomes & Measurements Differences between infants treated with peritoneal dialysis (PD) or hemodialysis (HD) in patient survival, technique survival, and access to kidney transplantation were examined using Cox regression analysis while adjusting for age at dialysis therapy initiation, sex, underlying kidney disease, and country of residence. Results 917 infants initiated dialysis therapy on PD, and 146, on HD. Median age at dialysis therapy initiation was 4.5 (IQR, 0.7-7.9) months, and median body weight was 5.7 (IQR, 3.7-7.5) kg. Although the groups were homogeneous regarding age and sex, infants treated with PD more often had congenital anomalies of the kidney and urinary tract (CAKUT; 48% vs 27%), whereas those on HD therapy more frequently had metabolic disorders (12% vs 4%). Risk factors for death were younger age at dialysis therapy initiation (HR per each 1-month later initiation, 0.95; 95% CI, 0.90-0.97) and non-CAKUT cause of chronic kidney failure (HR, 1.49; 95% CI, 1.08-2.04). Mortality risk and likelihood of transplantation were equal in PD and HD patients, whereas HD patients had a higher risk for changing dialysis treatment (adjusted HR, 1.64; 95% CI, 1.17-2.31). Limitations Inability to control for unmeasured confounders not included in the Registry database and missing data (ie, comorbid conditions). Low statistical power because of relatively small number of participants. Conclusions Despite a widespread preconception that HD should be reserved for cases in which PD is not feasible, in Europe, we found 1 in 8 infants in need of maintenance dialysis to be initiated on HD therapy. Patient characteristics at dialysis therapy initiation, prospective survival, and time to transplantation were very similar for infants initiated on PD or HD therapy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27955924</pmid><doi>10.1053/j.ajkd.2016.09.024</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3963-0803</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2017-05, Vol.69 (5), p.617-625 |
| issn | 0272-6386 1523-6838 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_500471 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Age Factors Cause of Death end-stage renal disease (ESRD) ESPN/ERA-EDTA Registry Europe European Registery for Children on Renal Replacement Therapy Female Glomerulonephritis - complications Health Services Accessibility hemodialysis (HD) Hemolytic-Uremic Syndrome - complications Humans Infant Infant, Newborn Ischemia - complications Kidney Diseases, Cystic - complications Kidney Failure, Chronic - etiology Kidney Failure, Chronic - therapy Kidney Transplantation - statistics & numerical data maintenance dialysis Male Metabolic Diseases - complications Mortality Nephrology outcome Pediatric nephrology peritoneal dialysis (PD) Peritoneal Dialysis - methods Proportional Hazards Models Registries Renal Dialysis - methods renal replacement therapy (RRT) Retrospective Studies RRT modality survival Survival Rate Time Factors Treatment Outcome Urogenital Abnormalities - complications Vasculitis - complications |
| title | Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T12%3A02%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Infants%20Requiring%20Maintenance%20Dialysis:%20Outcomes%20of%20Hemodialysis%20and%20Peritoneal%20Dialysis&rft.jtitle=American%20journal%20of%20kidney%20diseases&rft.au=Vidal,%20Enrico,%20MD,%20PhD&rft.aucorp=Spanish%20Pediatric%20Registry&rft.date=2017-05-01&rft.volume=69&rft.issue=5&rft.spage=617&rft.epage=625&rft.pages=617-625&rft.issn=0272-6386&rft.eissn=1523-6838&rft_id=info:doi/10.1053/j.ajkd.2016.09.024&rft_dat=%3Cproquest_swepu%3E1852665339%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1852665339&rft_id=info:pmid/27955924&rft_els_id=S0272638616305960&rfr_iscdi=true |