Recovery of Kidney Function in Children Treated with Maintenance Dialysis

被引：6

作者：

Bonthuis, Marjolein ^{[1
]}

Harambat, Jerome ^{[2
]}

Berard, Etienne ^{[3
]}

Cransberg, Karlien ^{[4
]}

Duzova, Ali ^{[5
]}

Garneata, Liliana ^{[6
]}

Herthelius, Maria ^{[7
]}

Lungu, Adrian C. ^{[8
,9
]}

Jahnukainen, Timo ^{[10
,11
]}

Kaltenegger, Lukas ^{[12
]}

Ariceta, Gema ^{[13
]}

Maurer, Elisabeth ^{[14
]}

Palsson, Runolfur ^{[15
,16
]}

Sinha, Manish D. ^{[17
]}

Testa, Sara ^{[18
]}

Groothoff, Jaap W. ^{[19
]}

Jager, Kitty J. ^{[1
]}

机构：

[1] Univ Amsterdam, Acad Med Ctr,European Dialysis & Transplant Assoc, Amsterdam Publ Hlth Res Inst,European Soc Pediat, European Renal Assoc,Dept Med Informat, Amsterdam, Netherlands

[2] Bordeaux Univ Hosp, Pediat Nephrol Unit, Bordeaux, France

[3] Hop Archet2, Ctr Hosp Univ Nice, Dept Pediat Nephrol, Nice, France

[4] Sophia Childrens Univ Hosp, Dept Pediat Nephrol, Erasmus Med Ctr, Rotterdam, Netherlands

[5] Hacettepe Univ, Div Pediat Nephrol, Dept Pediat, Fac Med, Ankara, Turkey

[6] Carol Davila Univ Med & Pharm, Dr Carol Davila Teaching Hosp Nephrol, Dept Internal Med & Nephrol, Bucharest, Romania

[7] Karolinska Inst, Karolinska Univ Hosp Huddinge, Stockholm, Sweden

[8] Fundeni Clin Inst, Dept Pediat Nephrol, Bucharest, Romania

[9] Carol Davila Univ Med, Pediat, Bucharest, Romania

[10] Helsinki Univ Hosp, Dept Pediat Nephrol & Transplantat, Helsinki, Finland

[11] Univ Helsinki, Helsinki, Finland

[12] Med Univ Vienna, Dept Pediat & Adolescent Med, Div Pediat Nephrol & Gastroenterol, Vienna, Austria

[13] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Pediat Nephrol Dept, Barcelona, Spain

[14] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland

[15] Landspitali, Div Nephrol, Reykjavik, Iceland

[16] Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland

[17] Guys & St Thomas Natl Hlth Serv Fdn Trust, Evelina London Childrens Hosp, Dept Pediat Nephrol, London, England

[18] CaGranda Osped Maggiore Policlin, Fdn Inst Ricovero & Cura Carattere Sci, Pediat Nephrol & Dialysis Unit, Milan, Italy

[19] Emma Childrens Hosp, Acad Med Ctr, Dept Pediat Nephrol, Amsterdam, Netherlands

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2018年 / 13卷 / 10期

关键词：

renal function recovery; chronic dialysis; pediatric nephrology; ESRD; renal dialysis; kidney transplantation; Edetic Acid; Incidence; Proportional Hazards Models; Kidney Failure; Chronic; peritoneal dialysis; kidney; Renal Insufficiency; Hemolytic-Uremic Syndrome; Registries; vasculitis; Cohort Studies; STAGE RENAL-FAILURE;

D O I：

10.2215/CJN.01500218

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectivesData on recovery of kidney function in pediatric patients with presumed ESKD are scarce. We examined the occurrence of recovery of kidney function and its determinants in a large cohort of pediatric patients on maintenance dialysis in Europe.Design, setting, participants, & measurementsData for 6574 patients from 36 European countries commencing dialysis at an age below 15 years, between 1990 and 2014 were extracted from the European Society for Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry. Recovery of kidney function was defined as discontinuation of dialysis for at least 30 days. Time to recovery was studied using a cumulative incidence competing risk approach and adjusted Cox proportional hazard models.ResultsTwo years after dialysis initiation, 130 patients (2%) experienced recovery of their kidney function after a median of 5.0 (interquartile range, 2.0-9.6) months on dialysis. Compared with patients with congenital anomalies of the kidney and urinary tract, recovery more often occurred in patients with vasculitis (11% at 2 years; adjusted hazard ratio [HR], 20.4; 95% confidence interval [95% CI], 9.7 to 42.8), ischemic kidney failure (12%; adjusted HR, 11.4; 95% CI, 5.6 to 23.1), and hemolytic uremic syndrome (13%; adjusted HR, 15.6; 95% CI, 8.9 to 27.3). Younger age and initiation on hemodialysis instead of peritoneal dialysis were also associated with recovery. For 42 patients (32%), recovery was transient as they returned to kidney replacement therapy after a median recovery period of 19.7 (interquartile range, 9.0-41.3) months.ConclusionsWe demonstrate a recovery rate of 2% within 2 years after dialysis initiation in a large cohort of pediatric patients on maintenance dialysis. There is a clinically important chance of recovery in patients on dialysis with vasculitis, ischemic kidney failure, and hemolytic uremic syndrome, which should be considered when planning kidney transplantation in these children.

引用

页码：1510 / 1516

页数：7

共 22 条

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