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Prolonged respiratory disorder predicts adverse prognosis in infants with end-stage kidney disease

Tomoyuki Sakai1, Yoshitaka Murakami2, Yusuke Okuda3

  • 1Department of Pediatrics, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan. sakai-tomoyuki@umin.ac.jp.

Pediatric Nephrology (Berlin, Germany)
|June 9, 2016
PubMed

Insights

Infants with end-stage kidney disease and prolonged respiratory disorders face higher mortality risks. Aggressive treatment may need reconsideration in these complex cases.

Area of Science:

  • Pediatric Nephrology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Pulmonary hypoplasia (PH) is a significant mortality risk in infants with end-stage kidney disease (ESKD).
  • Outcomes for infants with both ESKD and PH are not well-defined due to ambiguous PH diagnosis and severity criteria.

Purpose of the Study:

  • To evaluate the long-term outcomes of infants with ESKD and congenital pulmonary disorders.
  • To identify risk factors for mortality in infants with ESKD and prolonged respiratory disorders.

Main Methods:

  • A cohort of children initiating peritoneal dialysis during infancy (1990-2015) was followed.
  • Infants with respiratory disorders exceeding 28 days post-birth were analyzed for mortality risk.

Main Results:

  • The study followed 46 children (8 with prolonged respiratory disorders).
  • Overall 5-year survival was 79.5%, but significantly lower in the group with prolonged respiratory disorders (Hazard Ratio 8.32).

Conclusions:

  • Infants with ESKD and prolonged respiratory disorders have increased mortality risk.
  • Withholding aggressive treatment in these infants should be considered.
Abstract

Keywords:
End-stage kidney diseaseInfantPeritoneal dialysisPulmonary hypoplasiaSurvival analysisWithholding treatment

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