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

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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).

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References

  1. 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 1:146–162

    CAS  PubMed  Google Scholar 

  2. Alexander SR (1999) Pediatric end-stage renal diseases. Am J Kidney Dis 34:S102–S113

    PubMed  Google Scholar 

  3. 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

    Google Scholar 

  4. 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 69:1414–1419

    CAS  PubMed  Google Scholar 

  5. 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 30:334–342

    CAS  PubMed  Google Scholar 

  6. 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

  7. 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

    Google Scholar 

  8. 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

  9. 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 16:854–857

    CAS  PubMed  Google Scholar 

  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 152:166–171

    CAS  PubMed  Google Scholar 

  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 16:996–1001

    Article  CAS  PubMed  Google Scholar 

  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 6:78–81

    CAS  PubMed  Google Scholar 

  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 17:264–268

    CAS  PubMed  Google Scholar 

  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 17:456–461

    Article  PubMed  Google Scholar 

  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 13:404–417

    PubMed  Google Scholar 

  16. Honda M (1999) The 1997 report of the Japanese National Registry data on pediatric peritoneal dialysis patients. Perit Dial Int 19: S473–S478

    PubMed  Google Scholar 

  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–S449

    PubMed  Google Scholar 

  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 37:573–579

    CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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

    Google Scholar 

  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 10:136–145

    CAS  PubMed  Google Scholar 

  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–S483

    PubMed  Google Scholar 

  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 15:179–182

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  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 59:2361–2367

    Article  CAS  PubMed  Google Scholar 

  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

    Google Scholar 

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

    CAS  PubMed  Google Scholar 

  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 7:198–207

    PubMed  Google Scholar 

  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 12:2158–2162

    CAS  PubMed  Google Scholar 

  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

    Google Scholar 

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

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The Italian Registry of Pediatric Chronic Peritoneal Dialysis is supported by a grant from Baxter Italy.

Author information

Authors and Affiliations

  1. Nephrology, Dialysis and Transplantation Unit, G. Gaslini Institute, Largo G. Gaslini 5, 16148 Genoa, Italy

    Enrico Verrina, Laura Turrini Dertenois & Francesco Perfumo

  2. Epidemiology and Biostatistics Service, G. Gaslini Institute, Genova, Italy

    Maria Grazia Calevo

  3. Nephrology, Dialysis and Transplantation Unit, 1st Department of Pediatrics, University of Milan Medical School, Milan, Italy

    Alberto Edefonti

  4. Nephrology, Dialysis and Transplantation Unit, Regina Margherita Children’s Hospital, Turin, Italy

    Bruno Gianoglio

  5. Nephrology and Urology Department, Bambino Gesù Children’s Hospital, Rome, Italy

    Stefano Rinaldi

  6. Nephrology Division, Giovanni XXIII Children’s Hospital, Bari, Italy

    Palma Sorino

  7. Nephrology, Dialysis and Transplantation Unit, Pediatric Department, University of Padua Medical School, Padua, Italy

    Graziella Zacchello

  8. Nephrology and Dialysis Unit, Meyer Children’s Hospital, Florence, Italy

    Giancarlo Lavoratti

  9. Nephrology and Dialysis Unit, Di Cristina Children’s Hospital, Palermo, Italy

    Silvio Maringhini

  10. Nephrology and Dialysis Unit, Santobono Children’s Hospital, Naples, Italy

    Carmine Pecoraro

Authors
  1. Enrico Verrina
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  2. Alberto Edefonti
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  3. Bruno Gianoglio
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  4. Stefano Rinaldi
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  5. Palma Sorino
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  6. Graziella Zacchello
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  7. Giancarlo Lavoratti
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  8. Silvio Maringhini
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  9. Carmine Pecoraro
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  10. Maria Grazia Calevo
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  11. Laura Turrini Dertenois
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  12. Francesco Perfumo
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Corresponding author

Correspondence to Enrico Verrina.

Additional information

Dialysis centers and investigators participating in the Italian Registry of Pediatric Chronic Peritoneal Dialysis: Unità Operativa (U.O.) di Nefrologia, Ospedale San Lazzaro, Alba (G. Viglino); Servizio di Nefrologia, Ospedale Policlinico, Anzio (F. Della Grotta); Servizio Nefrologia Pediatrica, Clinica Pediatria, Ancona (I. Rätsch); Servizio di Nefrologia, Ospedale Mazzoni, Ascoli Piceno (M. Ragaiolo); U.O. di Nefrologia e Dialisi, Ospedale Giovanni XXIII, Bari (A.D. Caringella, P. Sorino); Istituto di Pediatrica Clinica, Bari (R. Penza); U.O. di Nefrologia e Dialisi, Ospedale Malpighi, Bologna (L. Catizone); U.O. di Nefrologia, Ospedale Umberto I, Brescia (S. Bassi); U.O. di Nefrologia, Ospedale Civile, Brescia (G. Cancarini); Servizio Nefrologia e Dialisi, Clinica Pediatrica, Ospedale Meyer, Firenze (G. Lavoratti); U.O. di Nefrologia Dialisi e Trapianto, Istituto G. Gaslini, Genova (F. Perfumo, E. Verrina); Clinica Pediatrica, Messina (C. Fede); U.O. di Nefrologia Dialisi e Trapianto, Clinica Pediatrica De Marchi, Milano (A. Edefonti, G. Ardissino); Nefrologia Adulto e Bambino, Università di Napoli (G. Capasso); U.O. di Nefrologia e Dialisi, Ospedale Santobono, Napoli (C. Pecoraro); U.O. di Nefrologia, Dialisi e Trapianto, Clinica Pediatrica, Università di Padova (G. Zacchello, B. Andreetta); U.O. di Nefrologia e Dialisi, Ospedale Di Cristina, Palermo (S. Maringhini); U.O. di Nefrologia, Ospedale Civico, Palermo (F. Caputo); U.O. di Nefrologia e Dialisi, Ospedale Silvestrini, Perugia (U. Buoncristiani); U.O. di Nefrologia, Ospedale Santo Spirito, Pescara (A. Ciofani); Dipartimento di Nefrologia e Urologia, Ospedale Bambino Gesù, Roma (G. Rizzoni, S. Rinaldi); Clinica Pediatrica, Policlinico Gemelli, Roma (E. Salvaggio); U.O. di Nefrologia Dialisi e Trapianto, Ospedale Regina Margherita, Torino (R. Coppo, B. Gianoglio)

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Verrina, E., Edefonti, A., Gianoglio, B. et al. A multicenter experience on patient and technique survival in children on chronic dialysis. Pediatr Nephrol 19, 82–90 (2004). https://doi.org/10.1007/s00467-003-1270-6

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  • DOI: https://doi.org/10.1007/s00467-003-1270-6

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