BACKGROUND: The mortality rate among children requiring renal replacement therapy is higher than in children without end-stage renal disease (ESRD). Some factors, such as hypoalbuminemia, high peritoneal transport rate, age, malnutrition, cardiovascular disease, and recurrent peritonitis, appear to be associated with lower survival in adult peritoneal dialysis patients. Data regarding risk factors of mortality in children with continuous ambulatory peritoneal dialysis (CAPD) are limited. The aims of this study were to analyze the clinical characteristics of patients and investigate if routinely used laboratory and clinical variables are independent risk factors for mortality in children on CAPD. METHODS: We performed a retrospective chart analysis of pediatric ESRD patients on CAPD between January 1997 and September 2008. 29 patients undergoing CAPD for more than 3 months were enrolled. An analysis was performed on clinical and biochemical variables for survivors and nonsurvivors to identify potential risk factors for mortality. RESULTS: Mean age was 12.18 +/- 4.57 years. During the follow-up period, 8 patients transferred to hemodialysis and 13 patients received deceased donor renal transplantation. By the end of the study, 5 patients had died. Actuarial survival rate at 2 and 5 years was 96.55% and 91.19% respectively. The major complication during therapy was peritonitis (1 episode/57.79 patient-months). In the univariate analysis, younger age at initiation of dialysis, presence of comorbid disease, higher peritoneal transport rate, increased protein losses through peritoneal dialysis, high total daily protein loss, hypoalbuminemia, and hypophosphatemia were variables associated with mortality in pediatric CAPD patients. However, in the multivariate analysis, only low serum albumin (b = -2.089, p = 0.006; hazard ratio 8.06, 95% confidence interval 0.028 - 0.546) was independently associated with mortality. CONCLUSION: Mortality was low in our pediatric patients receiving CAPD. Hypoalbuminemia showed a significant association with death in CAPD patients.
BACKGROUND: The mortality rate among children requiring renal replacement therapy is higher than in children without end-stage renal disease (ESRD). Some factors, such as hypoalbuminemia, high peritoneal transport rate, age, malnutrition, cardiovascular disease, and recurrent peritonitis, appear to be associated with lower survival in adult peritoneal dialysis patients. Data regarding risk factors of mortality in children with continuous ambulatory peritoneal dialysis (CAPD) are limited. The aims of this study were to analyze the clinical characteristics of patients and investigate if routinely used laboratory and clinical variables are independent risk factors for mortality in children on CAPD. METHODS: We performed a retrospective chart analysis of pediatric ESRDpatients on CAPD between January 1997 and September 2008. 29 patients undergoing CAPD for more than 3 months were enrolled. An analysis was performed on clinical and biochemical variables for survivors and nonsurvivors to identify potential risk factors for mortality. RESULTS: Mean age was 12.18 +/- 4.57 years. During the follow-up period, 8 patients transferred to hemodialysis and 13 patients received deceased donor renal transplantation. By the end of the study, 5 patients had died. Actuarial survival rate at 2 and 5 years was 96.55% and 91.19% respectively. The major complication during therapy was peritonitis (1 episode/57.79 patient-months). In the univariate analysis, younger age at initiation of dialysis, presence of comorbid disease, higher peritoneal transport rate, increased protein losses through peritoneal dialysis, high total daily protein loss, hypoalbuminemia, and hypophosphatemia were variables associated with mortality in pediatric CAPD patients. However, in the multivariate analysis, only low serum albumin (b = -2.089, p = 0.006; hazard ratio 8.06, 95% confidence interval 0.028 - 0.546) was independently associated with mortality. CONCLUSION: Mortality was low in our pediatric patients receiving CAPD. Hypoalbuminemia showed a significant association with death in CAPD patients.
Authors: Dagmara Borzych-Duzalka; T Fazil Aki; Marta Azocar; Colin White; Elizabeth Harvey; Sevgi Mir; Marta Adragna; Erkin Serdaroglu; Rajiv Sinha; Charlotte Samaille; Juan Jose Vanegas; Jameela Kari; Lorena Barbosa; Arvind Bagga; Monica Galanti; Onder Yavascan; Giovanna Leozappa; Maria Szczepanska; Karel Vondrak; Kei-Chiu Tse; Franz Schaefer; Bradley A Warady Journal: Clin J Am Soc Nephrol Date: 2016-11-29 Impact factor: 8.237
Authors: Alicia M Neu; Anja Sander; Dagmara Borzych-Duzalka; Alan R Watson; Patricia G Vallés; Il Soo Ha; Hiren Patel; David Askenazi; Irena Balasz-Chmielewska; Jouni Lauronen; Jaap W Groothoff; Janusz Feber; Franz Schaefer; Bradley A Warady Journal: Perit Dial Int Date: 2012 Jul-Aug Impact factor: 1.756
Authors: Nikki J Schoenmaker; Wilma F Tromp; Johanna H van der Lee; Brigitte Adams; Antonia H Bouts; Laure Collard; Karlien Cransberg; Rita van Damme-Lombaerts; Nathalie Godefroid; Koen J van Hoeck; Linda Koster-Kamphuis; Marc R Lilien; Ann Raes; Jaap W Groothoff Journal: Pediatr Nephrol Date: 2012-03-21 Impact factor: 3.714