Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death

  • Chang, Hye Jin (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Han, Kyoung Hee (Department of Pediatrics, Jeju National University Hospital) ;
  • Cho, Min Hyun (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Park, Young Seo (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kang, Hee Gyung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Cheong, Hae Il (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Ha, Il Soo (Department of Pediatrics, Seoul National University Children's Hospital)
  • Received : 2013.09.11
  • Accepted : 2013.10.10
  • Published : 2014.03.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

Keywords

References

  1. Warady BA, Chadha V. Chronic kidney disease in children: the global perspective. Pediatr Nephrol 2007;22:1999-2009. https://doi.org/10.1007/s00467-006-0410-1
  2. van der Heijden BJ, van Dijk PC, Verrier-Jones K, Jager KJ, Briggs JD. Renal replacement therapy in children: data from 12 registries in Europe. Pediatr Nephrol 2004;19:213-21. https://doi.org/10.1007/s00467-003-1376-x
  3. Chadha V, Warady BA. Epidemiology of pediatric chronic kidney disease. Adv Chronic Kidney Dis 2005;12:343-52. https://doi.org/10.1053/j.ackd.2005.07.013
  4. North American Pediatric Renal Trials and Collaborative Studies; 2011 Annual Dialysis Report [Internet]. Boston: NAPRTCS; [cited 2012 Aug 1]. Available from: https://web.emmes.com/study/ped/ annlrept/annualrept2011.pdf
  5. ESRD Registry Committee, KSoN; 2010 [Internet]. Seoul: Korean Society of Nephrology; c2006 [cited 2012 Aug 1]. Available from: http://www.ksn.or.kr/journal/2011/index.html.
  6. U.S. renal data system. The 2006 Annual data report: Atlas of endstage renal disease in the United States [Internet]. Minneapolis: USRDS Coordinating Center; [cited 2012 Aug 1]. Available from: http://www.usrds.org/atlas06.aspx.
  7. Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, et al. Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 2002;61:621-9. https://doi.org/10.1046/j.1523-1755.2002.00156.x
  8. Hattori S, Yosioka K, Honda M, Ito H; Japanese Society for Pediatric Nephrology. The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol 2002; 17:456-61. https://doi.org/10.1007/s00467-002-0848-8
  9. McDonald SP, Craig JC; Australian and New Zealand Paediatric Nephrology Association. Long-term survival of children with endstage renal disease. N Engl J Med 2004;350:2654-62. https://doi.org/10.1056/NEJMoa031643
  10. Lin HH, Tsai CW, Lin PH, Cheng KF, Wu HD, Wang IK, et al. Survival analysis of pediatric dialysis patients in Taiwan. Nephrology (Carlton) 2012;17:621-7. https://doi.org/10.1111/j.1440-1797.2012.01613.x
  11. Lee SE, Han KH, Jung YH, Lee HK, Kang HG, Cheong HI, et al. Peritonitis in children undergoing peritoneal dialysis: 10 years' experience in a single center. J Korean Soc Pediatr Nephrol 2010;14:174-83. https://doi.org/10.3339/jkspn.2010.14.2.174
  12. Keane WF, Alexander SR, Bailie GR, Boeschoten E, Gokal R, Golper TA, et al. Peritoneal dialysis-related peritonitis treatment recommendations: 1996 update. Perit Dial Int 1996;16:557-73.
  13. Wood EG, Hand M, Briscoe DM, Donaldson LA, Yiu V, Harley FL, et al. Risk factors for mortality in infants and young children on dialysis. Am J Kidney Dis 2001;37:573-9. https://doi.org/10.1053/ajkd.2001.22083
  14. Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, et al. Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol 2008;3:1526-33. https://doi.org/10.2215/CJN.00950208
  15. Shroff R, Rees L, Trompeter R, Hutchinson C, Ledermann S. Longterm outcome of chronic dialysis in children. Pediatr Nephrol 2006; 21:257-64. https://doi.org/10.1007/s00467-005-2067-6
  16. Agarwal R, Bunaye Z, Bekele DM, Light RP. Competing risk factor analysis of end-stage renal disease and mortality in chronic kidney disease. Am J Nephrol 2008;28:569-75. https://doi.org/10.1159/000115291
  17. Parekh RS, Carroll CE, Wolfe RA, Port FK. Cardiovascular mortality in children and young adults with end-stage kidney disease. J Pediatr 2002;141:191-7. https://doi.org/10.1067/mpd.2002.125910

Cited by

  1. Experience with Pediatric Kidney Transplantation, 1985-2016: A Single Regional Center Study vol.21, pp.2, 2017, https://doi.org/10.3339/jkspn.2017.21.2.69
  2. Survival in children requiring chronic renal replacement therapy vol.33, pp.4, 2014, https://doi.org/10.1007/s00467-017-3681-9