Treatment of children in the U.S. with end-stage renal disease (ESRD).

USA 10,434 children with End State Renal Disease or chronic renal insufficiency have been followed by NAPRTCS. 5958 renal transplants have been performed. Haemoidalysis preceeded Tx in 28%, PD in 47% and 24% were preemptive transplants. The most common diagnoses were obstructive uropathy, renal dysplasia, FSGN, reflux nephropathy and CGN. 20.4 were < 5 and 24.9% < 12 years or age a transplant. 57.7% had living related donors. The most common therapy is with prednisone, cyclosporine and mycophenalate mofetile. Time to 1st rejection episode is 755 days in LRD and 98 days in CD. 5 year patient survival is 93.5% and 5 year graft survival in LRD is 80% and in CD is 65%. 75 cases of PTLD have been reported. 3748 patients have had maintenance dialysis. Peritoneal dialysis was the main modality in 67% and hemodialysis in 39%. 0.86 episodes/year of peritonitis has occurred in PD patients. 94% of patients received EPO therapy and 15% received growth hormone therapy. 3 year patient survival on dialysis is 86.5% (69.5% in those < 1 to 92.4% in those > 12 yrs of age). 3863 patients with chronic renal insufficiency have been followed. Mean height by standard deviation score is -1.41 with one third -1.88. Growth hormone for one year increased SDS by -0.30.