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Outcomes of infants receiving chronic peritoneal dialysis: an analysis of the USRDS registry

Background Outcome data for infants on chronic peritoneal dialysis (CPD) is limited and has been based primarily on the analyses of voluntary entry registry data. In contrast, the United States Renal Data Systems (USRDS) collects data on all infants with end-stage kidney disease (ESKD) on chronic di... Full description

Journal Title: Pediatric nephrology (Berlin West), 2018, Vol.34 (1), p.155-162
Main Author: Sanderson, Keia R
Other Authors: Yu, Yichun , Dai, Hongying , Willig, Laurel K , Warady, Bradley A
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/30141177
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6289046
title: Outcomes of infants receiving chronic peritoneal dialysis: an analysis of the USRDS registry
format: Article
creator:
  • Sanderson, Keia R
  • Yu, Yichun
  • Dai, Hongying
  • Willig, Laurel K
  • Warady, Bradley A
subjects:
  • Age
  • Age Factors
  • Article
  • Care and treatment
  • Cause of Death - trends
  • Chronic kidney failure
  • Chronic peritoneal dialysis
  • Congenital defects
  • Continuous ambulatory peritoneal dialysis
  • End-stage renal disease
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Infants
  • Kidney diseases
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - therapy
  • Kidneys
  • Male
  • Medicine
  • Medicine & Public Health
  • Mortality
  • Neonates
  • Nephrology
  • Original Article
  • Patient outcomes
  • Pediatric ESKD
  • Pediatric research
  • Pediatrics
  • Peritoneal Dialysis
  • Peritoneum
  • Registries - statistics & numerical data
  • Retrospective Studies
  • Risk factors
  • Statistics
  • Survival
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • United States - epidemiology
  • Urinary tract
  • Urology
  • What's New in Dialysis
ispartof: Pediatric nephrology (Berlin, West), 2018, Vol.34 (1), p.155-162
description: Background Outcome data for infants on chronic peritoneal dialysis (CPD) is limited and has been based primarily on the analyses of voluntary entry registry data. In contrast, the United States Renal Data Systems (USRDS) collects data on all infants with end-stage kidney disease (ESKD) on chronic dialysis in the USA. We aimed to describe the clinical characteristics of this population and to determine the associated patient mortality. Methods The USRDS database was reviewed retrospectively for data on infants who initiated CPD at ≤ 12 months of age from 1990 to 2014. Infants were categorized into four groups, CPD initiation age (≤ 1 month of age or neonates and > 1–12 months of age or older infants) and initiation era (1990–1999 and 2000–2014). Results A total of 1723 infants (574 neonates and 1149 older infants) were identified. Overall, 20.9% of infants (147 neonates and 213 older infants) died on dialysis during the follow-up. The most commonly identified causes of death on dialysis were cardiorespiratory disease (25.8%) and infection (22.8%). There was an increased risk for mortality in all infants who initiated CPD in the earlier initiation era (1990–1999) vs the later era (2000–2014) (aHR of 1.95), for females vs males (aHR 1.43), and for those with a primary diagnosis of cystic kidney diseases vs congenital anomalies of the kidney and urinary tract (CAKUT) (aHR 1.84). In 2000–2014, patient survival at 1 and 5 years was 86.8% and 74.6% for those who initiated CPD as neonates and 89.6% and 79.3% for those who did so as older infants. Conclusions In this large cohort of infants who received chronic peritoneal dialysis over more than two decades, the probability of survival after initiating CPD in the first year of life has significantly improved. There is no difference in the probability of death for neonates compared to older infants. However, the mortality rate remains substantial in association with multiple risk factors.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleOutcomes of infants receiving chronic peritoneal dialysis: an analysis of the USRDS registry
creatorSanderson, Keia R ; Yu, Yichun ; Dai, Hongying ; Willig, Laurel K ; Warady, Bradley A
creatorcontribSanderson, Keia R ; Yu, Yichun ; Dai, Hongying ; Willig, Laurel K ; Warady, Bradley A
descriptionBackground Outcome data for infants on chronic peritoneal dialysis (CPD) is limited and has been based primarily on the analyses of voluntary entry registry data. In contrast, the United States Renal Data Systems (USRDS) collects data on all infants with end-stage kidney disease (ESKD) on chronic dialysis in the USA. We aimed to describe the clinical characteristics of this population and to determine the associated patient mortality. Methods The USRDS database was reviewed retrospectively for data on infants who initiated CPD at ≤ 12 months of age from 1990 to 2014. Infants were categorized into four groups, CPD initiation age (≤ 1 month of age or neonates and > 1–12 months of age or older infants) and initiation era (1990–1999 and 2000–2014). Results A total of 1723 infants (574 neonates and 1149 older infants) were identified. Overall, 20.9% of infants (147 neonates and 213 older infants) died on dialysis during the follow-up. The most commonly identified causes of death on dialysis were cardiorespiratory disease (25.8%) and infection (22.8%). There was an increased risk for mortality in all infants who initiated CPD in the earlier initiation era (1990–1999) vs the later era (2000–2014) (aHR of 1.95), for females vs males (aHR 1.43), and for those with a primary diagnosis of cystic kidney diseases vs congenital anomalies of the kidney and urinary tract (CAKUT) (aHR 1.84). In 2000–2014, patient survival at 1 and 5 years was 86.8% and 74.6% for those who initiated CPD as neonates and 89.6% and 79.3% for those who did so as older infants. Conclusions In this large cohort of infants who received chronic peritoneal dialysis over more than two decades, the probability of survival after initiating CPD in the first year of life has significantly improved. There is no difference in the probability of death for neonates compared to older infants. However, the mortality rate remains substantial in association with multiple risk factors.
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subjectAge ; Age Factors ; Article ; Care and treatment ; Cause of Death - trends ; Chronic kidney failure ; Chronic peritoneal dialysis ; Congenital defects ; Continuous ambulatory peritoneal dialysis ; End-stage renal disease ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Infants ; Kidney diseases ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Kidneys ; Male ; Medicine ; Medicine & Public Health ; Mortality ; Neonates ; Nephrology ; Original Article ; Patient outcomes ; Pediatric ESKD ; Pediatric research ; Pediatrics ; Peritoneal Dialysis ; Peritoneum ; Registries - statistics & numerical data ; Retrospective Studies ; Risk factors ; Statistics ; Survival ; Survival Rate ; Time Factors ; Treatment Outcome ; United States - epidemiology ; Urinary tract ; Urology ; What's New in Dialysis
ispartofPediatric nephrology (Berlin, West), 2018, Vol.34 (1), p.155-162
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descriptionBackground Outcome data for infants on chronic peritoneal dialysis (CPD) is limited and has been based primarily on the analyses of voluntary entry registry data. In contrast, the United States Renal Data Systems (USRDS) collects data on all infants with end-stage kidney disease (ESKD) on chronic dialysis in the USA. We aimed to describe the clinical characteristics of this population and to determine the associated patient mortality. Methods The USRDS database was reviewed retrospectively for data on infants who initiated CPD at ≤ 12 months of age from 1990 to 2014. Infants were categorized into four groups, CPD initiation age (≤ 1 month of age or neonates and > 1–12 months of age or older infants) and initiation era (1990–1999 and 2000–2014). Results A total of 1723 infants (574 neonates and 1149 older infants) were identified. Overall, 20.9% of infants (147 neonates and 213 older infants) died on dialysis during the follow-up. The most commonly identified causes of death on dialysis were cardiorespiratory disease (25.8%) and infection (22.8%). There was an increased risk for mortality in all infants who initiated CPD in the earlier initiation era (1990–1999) vs the later era (2000–2014) (aHR of 1.95), for females vs males (aHR 1.43), and for those with a primary diagnosis of cystic kidney diseases vs congenital anomalies of the kidney and urinary tract (CAKUT) (aHR 1.84). In 2000–2014, patient survival at 1 and 5 years was 86.8% and 74.6% for those who initiated CPD as neonates and 89.6% and 79.3% for those who did so as older infants. Conclusions In this large cohort of infants who received chronic peritoneal dialysis over more than two decades, the probability of survival after initiating CPD in the first year of life has significantly improved. There is no difference in the probability of death for neonates compared to older infants. However, the mortality rate remains substantial in association with multiple risk factors.
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0Age
1Age Factors
2Article
3Care and treatment
4Cause of Death - trends
5Chronic kidney failure
6Chronic peritoneal dialysis
7Congenital defects
8Continuous ambulatory peritoneal dialysis
9End-stage renal disease
10Female
11Follow-Up Studies
12Humans
13Infant
14Infant, Newborn
15Infants
16Kidney diseases
17Kidney Failure, Chronic - mortality
18Kidney Failure, Chronic - therapy
19Kidneys
20Male
21Medicine
22Medicine & Public Health
23Mortality
24Neonates
25Nephrology
26Original Article
27Patient outcomes
28Pediatric ESKD
29Pediatric research
30Pediatrics
31Peritoneal Dialysis
32Peritoneum
33Registries - statistics & numerical data
34Retrospective Studies
35Risk factors
36Statistics
37Survival
38Survival Rate
39Time Factors
40Treatment Outcome
41United States - epidemiology
42Urinary tract
43Urology
44What's New in Dialysis
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date2018-08-23
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volume34
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pages155-162
issn0931-041X
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abstractBackground Outcome data for infants on chronic peritoneal dialysis (CPD) is limited and has been based primarily on the analyses of voluntary entry registry data. In contrast, the United States Renal Data Systems (USRDS) collects data on all infants with end-stage kidney disease (ESKD) on chronic dialysis in the USA. We aimed to describe the clinical characteristics of this population and to determine the associated patient mortality. Methods The USRDS database was reviewed retrospectively for data on infants who initiated CPD at ≤ 12 months of age from 1990 to 2014. Infants were categorized into four groups, CPD initiation age (≤ 1 month of age or neonates and > 1–12 months of age or older infants) and initiation era (1990–1999 and 2000–2014). Results A total of 1723 infants (574 neonates and 1149 older infants) were identified. Overall, 20.9% of infants (147 neonates and 213 older infants) died on dialysis during the follow-up. The most commonly identified causes of death on dialysis were cardiorespiratory disease (25.8%) and infection (22.8%). There was an increased risk for mortality in all infants who initiated CPD in the earlier initiation era (1990–1999) vs the later era (2000–2014) (aHR of 1.95), for females vs males (aHR 1.43), and for those with a primary diagnosis of cystic kidney diseases vs congenital anomalies of the kidney and urinary tract (CAKUT) (aHR 1.84). In 2000–2014, patient survival at 1 and 5 years was 86.8% and 74.6% for those who initiated CPD as neonates and 89.6% and 79.3% for those who did so as older infants. Conclusions In this large cohort of infants who received chronic peritoneal dialysis over more than two decades, the probability of survival after initiating CPD in the first year of life has significantly improved. There is no difference in the probability of death for neonates compared to older infants. However, the mortality rate remains substantial in association with multiple risk factors.
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pubSpringer Berlin Heidelberg
pmid30141177
doi10.1007/s00467-018-4056-6
orcididhttps://orcid.org/0000-0001-7759-4220
oafree_for_read