Mortality risk in European children with end-stage renal disease on dialysis

Nicholas C. Chesnaye, Franz Schaefer, Jaap W. Groothoff, Marjolein Bonthuis, G. Reusz, James G. Heaf, Malcolm Lewis, Elisabeth Maurer, Dušan Paripović, Ilona Zagozdzon, Karlijn J. van Stralen, Kitty J. Jager

Research output: Contribution to journalArticle

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Abstract

We aimed to describe survival in European pediatric dialysis patients and compare the differential mortality risk between patients starting on hemodialysis (HD) and peritoneal dialysis (PD). Data for 6473 patients under 19 years of age or younger were extracted from the European Society of Pediatric Nephrology, the European Renal Association, and European Dialysis and Transplant Association Registry for 36 countries for the years 2000 through 2013. Hazard ratios (HRs) were adjusted for age at start of dialysis, sex, primary renal disease, and country. A secondary analysis was performed on a propensity score–matched (PSM) cohort. The overall 5–year survival rate in European children starting on dialysis was 89.5% (95% confidence interval [CI] 87.7%–91.0%). The mortality rate was 28.0 deaths per 1000 patient years overall. This was highest (36.0/1000) during the first year of dialysis and in the 0- to 5-year age group (49.4/1000). Cardiovascular events (18.3%) and infections (17.0%) were the main causes of death. Children selected to start on HD had an increased mortality risk compared with those on PD (adjusted HR 1.39, 95% CI 1.06–1.82, PSM HR 1.46, 95% CI 1.06–2.00), especially during the first year of dialysis (HD/PD adjusted HR 1.70, 95% CI 1.22–2.38, PSM HR 1.79, 95% CI 1.20–2.66), when starting at older than 5 years of age (HD/PD: adjusted HR 1.58, 95% CI 1.03–2.43, PSM HR 1.87, 95% CI 1.17–2.98) and when children have been seen by a nephrologist for only a short time before starting dialysis (HD/PD adjusted HR 6.55, 95% CI 2.35–18.28, PSM HR 2.93, 95% CI 1.04–8.23). Because unmeasured case-mix differences and selection bias may explain the higher mortality risk in the HD population, these results should be interpreted with caution.

Original languageEnglish
Pages (from-to)1355-1362
Number of pages8
JournalKidney International
Volume89
Issue number6
DOIs
Publication statusPublished - 2016

Fingerprint

Chronic Kidney Failure
Dialysis
Confidence Intervals
Peritoneal Dialysis
Renal Dialysis
Mortality
Selection Bias
Diagnosis-Related Groups
Registries
Cause of Death
Survival Rate
Age Groups
Pediatrics
Transplants
Kidney
Survival
Infection
Population

Keywords

  • dialysis modality
  • end-stage renal disease
  • mortality risk factors
  • pediatric nephrology

ASJC Scopus subject areas

  • Nephrology

Cite this

Chesnaye, N. C., Schaefer, F., Groothoff, J. W., Bonthuis, M., Reusz, G., Heaf, J. G., ... Jager, K. J. (2016). Mortality risk in European children with end-stage renal disease on dialysis. Kidney International, 89(6), 1355-1362. https://doi.org/10.1016/j.kint.2016.02.016

Mortality risk in European children with end-stage renal disease on dialysis. / Chesnaye, Nicholas C.; Schaefer, Franz; Groothoff, Jaap W.; Bonthuis, Marjolein; Reusz, G.; Heaf, James G.; Lewis, Malcolm; Maurer, Elisabeth; Paripović, Dušan; Zagozdzon, Ilona; van Stralen, Karlijn J.; Jager, Kitty J.

In: Kidney International, Vol. 89, No. 6, 2016, p. 1355-1362.

Research output: Contribution to journalArticle

Chesnaye, NC, Schaefer, F, Groothoff, JW, Bonthuis, M, Reusz, G, Heaf, JG, Lewis, M, Maurer, E, Paripović, D, Zagozdzon, I, van Stralen, KJ & Jager, KJ 2016, 'Mortality risk in European children with end-stage renal disease on dialysis', Kidney International, vol. 89, no. 6, pp. 1355-1362. https://doi.org/10.1016/j.kint.2016.02.016
Chesnaye, Nicholas C. ; Schaefer, Franz ; Groothoff, Jaap W. ; Bonthuis, Marjolein ; Reusz, G. ; Heaf, James G. ; Lewis, Malcolm ; Maurer, Elisabeth ; Paripović, Dušan ; Zagozdzon, Ilona ; van Stralen, Karlijn J. ; Jager, Kitty J. / Mortality risk in European children with end-stage renal disease on dialysis. In: Kidney International. 2016 ; Vol. 89, No. 6. pp. 1355-1362.
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