Late somatic and psycho-social consequences of renal insufficiency in children

The aim of the project was to establish the somatic and psycho-social consequences in adulthood of paediatric end-stage renal disease (ESRD). A long term follow up study of all Dutch patients who started renal replacement therapy at age 0-15 years between 1972 and 1992 and who were born before 1979 was undertaken. The study was performed between 1998 and 2000. About 25% of patients had died at time of investigation. Cardiovascular abnormalities were prominent in both transplanted and dialysis patients and cardiovascular disease was also found to be the most prominent cause of death. Skeletal disorders as a result of metabolic bone disease accounted for most frequent occurring disabilities. The risk for malignancies was 10-fold that of the normal population. Mean IQ and educational attainment were low as compared to the normal population. The overall quality of life was good, despite the co-morbidity and disabilities. Adverse outcomes were in nearly all cases related to a prolonged period of dialysis in the past and to (current) hypertension, not to the state of dialysis at time of investigation.