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Long-term results in children following dialysis and renal transplantation
Insights
This study followed 93 children with end-stage renal disease treated with dialysis and transplantation since 1966. Most survivors are in good rehabilitation categories, showing positive outcomes for pediatric renal replacement therapy.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Uremia Management
Background:
- End-stage renal disease (ESRD) significantly impacts children's health and development.
- Combined treatment strategies involving dialysis and transplantation are crucial for managing pediatric ESRD.
- Long-term outcomes for children undergoing renal replacement therapy require continuous evaluation.
Purpose of the Study:
- To evaluate the outcomes of a combined dialysis and transplantation program for children with end-stage renal disease.
- To assess the long-term rehabilitation status of pediatric patients receiving renal replacement therapy.
- To analyze survival rates and graft function in children treated for ESRD.
Main Methods:
- Retrospective analysis of 93 children (aged 5-16 years) treated from 1966 onwards.
- Inclusion of patients managed with hospital hemodialysis, home hemodialysis, and renal transplantation.
- Assessment of patient survival, graft function, and rehabilitation status using EDTA categories.
Main Results:
- Over 90 dialysis years were accumulated across 91 patients initiating uraemia treatment.
- Forty-one children underwent renal transplantation, with 7 deaths post-transplant.
- Currently, 66 children are alive: 25 with functioning grafts, 28 on hospital dialysis, and 13 on home hemodialysis.
- 83% of hospital dialysis patients are in rehabilitation category 2; all home dialysis and transplant patients are in category 1.
Conclusions:
- Combined dialysis and transplantation programs offer viable long-term solutions for pediatric end-stage renal disease.
- High rates of survival and good rehabilitation outcomes are achievable with modern renal replacement therapies in children.
- Home hemodialysis and functioning grafts correlate with superior rehabilitation outcomes (EDTA category 1).
Abstract:
Since 1966, 93 children in end-stage renal disease, aged between 5 and 16 years were treated by a combined programme of dialysis and transplantation. In 91 patients treatment of uraemia was started either as hospital or home haemodialysis, until now covering more than 90 dialysis years. Forty-one children were transplanted. Twenty children died during dialysis treatment, 7 after renal transplantation. Sixty-six children are currently alive, 25 with a functioning graft, 28 are treated by hospital dialysis, 13 by home haemodialysis. Eighty-three per cent of the patients on hospital dialysis are classified in rehabilitation category 2 according to the EDTA categories, and all children on home dialysis and those with functioning grafts, category 1.