End-stage renal disease in Japanese children: a nationwide survey during 2006-2011
Motoshi Hattori1, Mayumi Sako2, Tetsuji Kaneko3
1Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. hattori@kc.twmu.ac.jp.
Insights
Pediatric end-stage renal disease (ESRD) incidence is lower in Japan than in other high-income nations. Pre-emptive transplantation has significantly increased as an initial treatment since 1998.
Area of Science:
- Pediatric Nephrology
- Renal Epidemiology
- Public Health
Background:
- End-stage renal disease (ESRD) is a rare but severe condition in children.
- Understanding global pediatric ESRD epidemiology is crucial for improving patient care.
- The Japanese Society for Pediatric Nephrology (JSPN) last surveyed pediatric ESRD data in 1998.
Purpose of the Study:
- To update epidemiological and demographic data on pediatric ESRD patients in Japan.
- To assess changes in incidence, causes, treatment, and survival since the last survey.
- To provide current insights into pediatric ESRD management in Japan.
Main Methods:
- A cross-sectional nationwide survey conducted by the JSPN in 2012.
- Data collected on pediatric patients (<20 years) with ESRD between 2006-2011.
- Analysis of incidence, primary renal disease, initial treatment modalities, and survival rates.
Main Results:
- The average incidence of pediatric ESRD was 4.0 per million population.
- Congenital anomalies of the kidney and urinary tract were the leading cause (39.8%).
- Pre-emptive transplantation (Tx) increased significantly as an initial treatment modality (22.3%).
- The Japanese renal replacement therapy (RRT) mortality rate was 18.2 deaths per 1000 person-years.
Conclusions:
- Pediatric ESRD incidence in Japan is lower compared to other high-income countries.
- There has been a substantial rise in pre-emptive Tx for Japanese children with ESRD since 1998.
- Continued monitoring of pediatric ESRD trends is essential for effective patient management.
Background:
End-stage renal disease (ESRD) in children is considered a rare, but serious condition. Epidemiological and demographic information on pediatric ESRD patients around the world is important to better understand this disease and to improve patient care. The Japanese Society for Pediatric Nephrology (JSPN) reported epidemiological and demographic data in 1998. Since then, however, there has been no nationwide survey on Japanese children with ESRD.
Methods:
The JSPN conducted a cross-sectional nationwide survey in 2012 to update information on the incidence, primary renal disease, initial treatment modalities, and survival in pediatric Japanese patients with ESRD aged less than 20 years during the period 2006-2011.
Results:
The average incidence of ESRD was 4.0 per million age-related population. Congenital anomalies of the kidney and urinary tract were the most common cause of ESRD, present in 39.8 % of these patients. In addition, 12.2 % had focal segmental glomerulosclerosis and 5.9 % had glomerulonephritis. Initial treatment modalities in patients who commenced renal replacement therapy (RRT) consisted of peritoneal dialysis, hemodialysis, and pre-emptive transplantation (Tx) in 61.7, 16.0, and 22.3 %, respectively. The Japanese RRT mortality rate was 18.2 deaths per 1000 person-years of observation.
Conclusion:
The incidence of ESRD is lower in Japanese children than in children of other high-income countries. Since 1998, notably, there has been a marked increase in pre-emptive Tx as an initial treatment modality for Japanese children with ESRD.
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