Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry.
Am J Kidney Dis
; 78(3): 380-390, 2021 09.
Article
en En
| MEDLINE
| ID: mdl-33549627
ABSTRACT
RATIONALE & OBJECTIVE:
Research on pediatric kidney replacement therapy (KRT) has primarily focused on Europe and North America. In this study, we describe the mortality risk of children treated with maintenance peritoneal dialysis (MPD) in different parts of the world and characterize the associated demographic and macroeconomic factors. STUDYDESIGN:
Prospective cohort study. SETTING &PARTICIPANTS:
Patients younger than 19 years at inclusion into the International Pediatric Peritoneal Dialysis Network registry, who initiated MPD between 1996 and 2017. EXPOSURE Region as primary exposure (Asia, Western Europe, Eastern Europe, Latin America, North America, and Oceania). Other demographic, clinical, and macroeconomic (4 income groups based on gross national income) factors also were studied.OUTCOME:
All-cause MPD mortality. ANALYTICALAPPROACH:
Patients were observed for 3 years, and the mortality rates in different regions and income groups were calculated. Cause-specific hazards models with random effects were fit to calculate the proportional change in variance for factors that could explain variation in mortality rates.RESULTS:
A total of 2,956 patients with a median age of 7.8 years at the start of KRT were included. After 3 years, the overall probability of death was 5%, ranging from 2% in North America to 9% in Eastern Europe. Mortality rates were higher in low-income countries than in high-income countries. Income category explained 50.1% of the variance in mortality risk between regions. Other explanatory factors included peritoneal dialysis modality at start (22.5%) and body mass index (11.1%).LIMITATIONS:
The interpretation of interregional survival differences as found in this study may be hampered by selection bias.CONCLUSIONS:
This study shows that the overall 3-year patient survival on pediatric MPD is high, and that country income is associated with patient survival.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Diálisis Peritoneal
/
Fallo Renal Crónico
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
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Child, preschool
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
/
Asia
/
Europa
Idioma:
En
Revista:
Am J Kidney Dis
Año:
2021
Tipo del documento:
Article
País de afiliación:
Países Bajos