Document Detail


Twenty-five years of infant dialysis: a single center experience.
MedLine Citation:
PMID:  19324367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To perform a retrospective analysis of the long-term outcome of infants with end-stage kidney disease (ESKD) treated at our center during the past 25 years. STUDY DESIGN: The total cohort (n = 52) was divided into era 1 (1983-1995; n = 23) and era 2 (1996-2008; n = 29). Dialysis morbidity, transplantation, and long-term survival rates were assessed and compared between the 2 eras. RESULTS: Average age at initiation of dialysis was 4.4 +/- 5.3 months (range, 0.5-18 months), with 96% begun on peritoneal dialysis. The predominant diagnoses were dysplasia/obstructive uropathy and autosomal recessive polycystic kidney disease. The overall survival rate is 46%, with current age of survivors ranging from 1.5 to 25 years. Mortality rates in the 2 eras were not significantly different. The predominant mortality occurred within the first year. Twenty-four patients received an initial renal transplant at 2.6 +/- 1.7 years of age. Six patients (25%) required a second renal allograft. Increased risk for mortality included African-American ethnicity, oligoanuria, autosomal recessive polycystic kidney disease, and co-morbid diagnoses. CONCLUSIONS: Long-term survival is possible in infants with ESKD, although mortality and morbidity remain high. Technical innovations are needed to accommodate smaller infants undergoing dialysis. Early initiation of dialysis treatment is preferable because prognostic indicators remain poorly defined.
Authors:
Rana Hijazi; Carolyn L Abitbol; Jayanthi Chandar; Wacharee Seeherunvong; Michael Freundlich; Gastón Zilleruelo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-25
Journal Detail:
Title:  The Journal of pediatrics     Volume:  155     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-29     Completed Date:  2009-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  111-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Pediatric Nephrology, University of Miami/Holtz Children's Hospital, Miami, FL, USA.
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Anuria / epidemiology
Child, Preschool
Cohort Studies
Comorbidity
Developmental Disabilities / epidemiology
Female
Florida / epidemiology
Gastrostomy
Humans
Infant
Infant, Newborn
Kidney Failure, Chronic / mortality*,  therapy*
Liver Transplantation / statistics & numerical data*
Male
Oliguria / epidemiology
Peritonitis / epidemiology
Polycystic Kidney Diseases / epidemiology
Renal Dialysis*
Retrospective Studies
Survival Analysis
Ureteral Obstruction / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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