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Renal replacement therapy in children: data from 12 registries in Europe

Bert J van der Heijden1, Paul C W van Dijk, Kate Verrier-Jones

  • 1Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.

Pediatric Nephrology (Berlin, Germany)
|December 20, 2003
PubMed

Insights

Pediatric renal replacement therapy (RRT) prevalence is rising, with stable incidence. Survival rates have significantly improved for both dialysis and transplant patients, indicating better outcomes in recent years.

Area of Science:

  • Pediatric Nephrology
  • Renal Epidemiology
  • Public Health

Background:

  • The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry collects data on renal replacement therapy (RRT).
  • Pediatric RRT data from 12 registries were analyzed, covering patients under 20 years old from 1980 to 2000.

Purpose of the Study:

  • To analyze trends in the incidence, prevalence, treatment modalities, and outcomes of RRT in children.
  • To assess changes in patient survival for pediatric RRT over two decades.

Main Methods:

  • Retrospective analysis of RRT data from 3,184 pediatric patients (aged <20 years) across 12 registries.
  • Data collection spanned from 1980 to the end of 2000, with incidence and prevalence rates calculated per million age-related population (pmarp).

Main Results:

  • RRT incidence increased from 1980-1984 to 1985-1989, then stabilized. Prevalence steadily rose from 22.9 pmarp in 1980 to 62.1 pmarp in 2000.
  • Peritoneal dialysis gained popularity, and pre-emptive transplantation represented 18% of initial treatments in 1995-2000.
  • Relative risk of death decreased significantly for patients starting dialysis (36%) and receiving transplants (42%) in 1995-2000 compared to 1980-1984.

Conclusions:

  • Pediatric RRT prevalence continues to increase, while incidence has remained stable for approximately 15 years.
  • Patient survival has demonstrably improved for both pediatric dialysis and transplant recipients.
  • The established pediatric registry provides a foundation for future in-depth research on pediatric RRT.

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