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[REIN: a tool at the service of the paediatric patients]
Étienne Bérard1, Jérôme Harambat2, Julien Hogan3
1Coordination nationale pédiatrique, CHU de Nice, France
Insights
Paediatric end-stage kidney disease (ESKD) patients face high mortality risks. The French REIN registry highlights treatment specificities and shows renal transplant as the leading therapy for children, improving life expectancy.
Area of Science:
- Nephrology
- Epidemiology
- Public Health
Background:
- Paediatric stage 5 chronic kidney disease (CKD) presents unique challenges with mortality rates 30 times higher than in the general pediatric population.
- The French Renal Epidemiology and Information Network (REIN) registry offers critical insights into this vulnerable group.
Purpose of the Study:
- To analyze the specificities of paediatric stage 5 CKD in France using the REIN registry.
- To provide indicators for patient outcomes and replacement therapy choices in paediatric CKD.
- To compare French incidence and prevalence rates with other European countries.
Main Methods:
- Analysis of data from the national French ESKD register (REIN).
- Description of patient outcomes and treatment modalities.
- Comparative analysis of incidence and prevalence with European data.
Main Results:
- France shows mid-range incidence and prevalence of stage 5 CKD in children compared to Europe.
- Renal transplantation is the primary treatment for children under 18, significantly improving life expectancy.
- Nationwide registries are crucial for unbiased analysis of this rare, highly specialized patient population.
Conclusions:
- The REIN registry effectively illustrates the specificities of paediatric stage 5 CKD in France.
- Renal transplantation offers the best life expectancy for affected children and adolescents.
- Collaboration through national and international registries is vital for advancing treatment practices and improving outcomes.
Abstract:
On the occasion of the 20th anniversary of the REIN (French Renal Epidemiology and Information Network), a summary work on the contributions of the national French ESKD register was carried out. On the issue of paediatric CKD patients, the following key messages were retained. Paediatric stage 5 chronic kidney disease (CKD) has particularities that require to be analysed and taken into account because the mortality of these patients remains 30 times higher than that of children of the same age. The REIN registry enables illustrating the specificities of stage 5 CKD in the paediatric age-group in France and providing a set of indicators making it possible to describe the future of these patients as well as the choices made concerning the modalities of replacement therapy. As compared to other European countries, the incidence and prevalence of stage 5 CKD in France is in the middle range for children under 15 and 20 years old. Renal transplant is by far the leading treatment for stage 5 CKD in children and adolescents under 18 years of age in France, allowing to offer these patients the best possible life expectancy. Owing to the small volume of patients, only a nationwide registry can provide an unbiased view and enables analysing this population requiring a hyperspecialised treatment. The participation of French paediatric nephrologists in the REIN French registry also enables providing input to the European registry (ESPN/ERA www.espn-reg.org/index.jsp) and the international registry (IPNA https://ipna-registry.org) (Consulted on September 15th 2022) and thus the possibility of international studies, which are vital to be in line with an approach to improving practices.
