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The changing pattern of children's dialysis and transplantation over 20 years

D Goh1, J H Evans, I B Houston

  • 1Royal Manchester Childrens Hospital, UK.

Clinical Nephrology
|October 1, 1994
PubMed

Insights

Treatment for children with chronic renal failure (CRF) has improved, with increased referrals and better survival rates for those starting renal replacement therapy (RRT) in later years.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy Outcomes
  • Epidemiology of Chronic Kidney Disease in Children

Background:

  • Assessing trends in pediatric chronic renal failure (CRF) treatment and outcomes.
  • Evaluating changes over a 20-year period (1968-1988) in a specific region.
  • Understanding the evolving landscape of pediatric end-stage renal disease (ESRD).

Purpose of the Study:

  • To analyze the changing patterns of treatment and outcomes for children with CRF.
  • To investigate referral trends and survival rates for pediatric renal replacement therapy (RRT).
  • To inform future care provision for children with ESRD.

Main Methods:

  • Retrospective analysis of 108 children referred for RRT.
  • Examination of referral data across consecutive 5-year periods.
  • Comparison of 5-year survival rates between different time cohorts.

Main Results:

  • Referrals increased significantly over 20 years, with a notable rise in very young children (<5 years).
  • The incidence of new referrals reached 8.5 per million childhood population by 1983-87.
  • Five-year survival rates improved substantially, from 56% (1968-72) to 88% (1978-82).

Conclusions:

  • Improved survival rates and increasing referrals, especially in young children, necessitate adjustments in care planning for pediatric ESRD.
  • The study highlights significant advancements in pediatric RRT over two decades.
  • Effective management strategies are crucial given the growing number of children requiring RRT.

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