Impact of Pediatric Chronic Dialysis on Long-Term Patient Outcome: Single Center Study

Abstract EN

Objective.

Owing to a shortage of kidney donors in Israel, children with end-stage renal disease (ESRD) may stay on maintenance dialysis for a considerable time, placing them at a significant risk.

The aim of this study was to understand the causes of mortality.

Study Design.

Clinical data were collected retrospectively from the files of children on chronic dialysis (>3 months) during the years 1995–2013 at a single pediatric medical center.

Results.

110 patients were enrolled in the study.

Mean age was 10.7 ± 5 .

27 yrs.

(range: 1 month–24 yrs).

Forty-five children (42 % ) had dysplastic kidneys and 19 (17.5 % ) had focal segmental glomerulosclerosis.

Twenty-five (22.7 % ) received peritoneal dialysis, 59 (53.6 % ) hemodialysis, and 6 (23.6 % ) both modalities sequentially.

Median dialysis duration was 1.46 years (range: 0.25–17.54 years).

Mean follow-up was 13.5 ± 5 .

84 yrs.

Seventy-nine patients (71.8 % ) underwent successful transplantation, 10 (11.2 % ) had graft failure, and 8 (7.3 % ) continued dialysis without transplantation.

Twelve patients (10.9 % ) died: 8 of dialysis-associated complications and 4 of their primary illness.

The 5-year survival rate was 84 % : 90 % for patients older than 5 years and 61 % for younger patients.

Conclusions.

Chronic dialysis is a suitable temporary option for children awaiting renal transplantation.

Although overall long-term survival rate is high, very young children are at high risk for life-threatening dialysis-associated complications.