Fabio Paglialonga1, Enrico Vidal2, Carmine Pecoraro3, Isabella Guzzo4, Mario Giordano5, Bruno Gianoglio6, Ciro Corrado7, Rosa Roperto8, Ilse Ratsch9, Salvatore Luzio10, Luisa Murer2, Silvia Consolo11, Giovanni Pieri11, Giovanni Montini11, Alberto Edefonti11, Enrico Verrina10. 1. Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy. fabio.paglialonga@policlinico.mi.it. 2. Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University-Hospital, Padua, Italy. 3. Nephrology and Dialysis Unit, Santobono Children's Hospital, Naples, Italy. 4. Nephrology and Dialysis Unit, Department of Pediatrics, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy. 5. Nephrology Division and Dialysis Unit, Giovanni XXIII Children's Hospital, Bari, Italy. 6. Nephrology Dialysis and Transplantation Unit, Regina Margherita University Hospital, Turin, Italy. 7. Pediatric Nephrology and Dialysis Unit, Children's Hospital G. Di Cristina, Palermo, Italy. 8. Nephrology and Dialysis Unit, Meyer Children's Hospital, Florence, Italy. 9. University Department of Pediatrics, United Hospitals of Ancona, Ancona, Italy. 10. Dialysis Unit, Paediatric Nephrology and Dialysis Department, G Gaslini Children Hospital, Genoa, Italy. 11. Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
Abstract
BACKGROUND: High volume haemodiafiltration (HDF) is associated with better survival than conventional haemodialysis (HD) in adults, but data concerning its use in children are lacking. The aim of this study was to assess the prevalence of paediatric HDF use and its associated factors in recent years in Italy. METHODS: We retrospectively reviewed the files of patients from the Italian Pediatric Dialysis Registry's database who were registered between January 1, 2004 and December 31, 2016 and treated with extracorporeal dialysis for at least 6 months, looking in particular at modality and its associated factors. RESULTS: One hundred forty-one out of 198 patients were treated exclusively with bicarbonate HD (71.2%), 57 with HDF (28.8%). Patients treated with HDF were younger (median 9.7 vs 13.2 years, p = 0.0008), were less often incident patients (52.6% vs 75.9%, p = 0.0031), had longer duration of the HD cycle (26.9 vs 20.8 months, p = 0.0036) and had a longer time to renal transplantation (32 vs 25 months, p = 0.0029) than those treated with bicarbonate HD only. The percentage of patients treated with HDF increased with dialysis vintage (16.9% at 6 months, 38.1% after more than 2 years of dialysis). The use of HDF was stable over time and was more common in the largest centres. CONCLUSIONS: Over the observation period, HDF use in Italy has been limited to roughly a quarter of patients on extracorporeal dialysis, in particular to those with high dialysis vintage, younger age or a long expected waiting time to renal transplantation.
BACKGROUND: High volume haemodiafiltration (HDF) is associated with better survival than conventional haemodialysis (HD) in adults, but data concerning its use in children are lacking. The aim of this study was to assess the prevalence of paediatric HDF use and its associated factors in recent years in Italy. METHODS: We retrospectively reviewed the files of patients from the Italian Pediatric Dialysis Registry's database who were registered between January 1, 2004 and December 31, 2016 and treated with extracorporeal dialysis for at least 6 months, looking in particular at modality and its associated factors. RESULTS: One hundred forty-one out of 198 patients were treated exclusively with bicarbonateHD (71.2%), 57 with HDF (28.8%). Patients treated with HDF were younger (median 9.7 vs 13.2 years, p = 0.0008), were less often incident patients (52.6% vs 75.9%, p = 0.0031), had longer duration of the HD cycle (26.9 vs 20.8 months, p = 0.0036) and had a longer time to renal transplantation (32 vs 25 months, p = 0.0029) than those treated with bicarbonateHD only. The percentage of patients treated with HDF increased with dialysis vintage (16.9% at 6 months, 38.1% after more than 2 years of dialysis). The use of HDF was stable over time and was more common in the largest centres. CONCLUSIONS: Over the observation period, HDF use in Italy has been limited to roughly a quarter of patients on extracorporeal dialysis, in particular to those with high dialysis vintage, younger age or a long expected waiting time to renal transplantation.
Authors: Amanda Y Wang; Toshiharu Ninomiya; Anas Al-Kahwa; Vlado Perkovic; Martin P Gallagher; Carmel Hawley; Meg J Jardine Journal: Am J Kidney Dis Date: 2014-03-28 Impact factor: 8.860
Authors: Ionut Nistor; Suetonia C Palmer; Jonathan C Craig; Valeria Saglimbene; Mariacristina Vecchio; Adrian Covic; Giovanni F M Strippoli Journal: Am J Kidney Dis Date: 2014-01-14 Impact factor: 8.860
Authors: Ira M Mostovaya; Muriel P C Grooteman; Carlo Basile; Andrew Davenport; Camiel L M de Roij van Zuijdewijn; Christoph Wanner; Menso J Nubé; Peter J Blankestijn Journal: Clin Kidney J Date: 2015-06-10