Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry.
Adolescent
Anemia
/ etiology
Calcium
/ blood
Child
Child, Preschool
Female
Ferritins
/ blood
Germany
Glomerular Filtration Rate
Glomerulonephritis
/ complications
Hemoglobins
/ metabolism
Humans
Hyperphosphatemia
/ etiology
Hypertension
/ etiology
Hypoalbuminemia
/ etiology
Kidney Failure, Chronic
/ etiology
Kidney Glomerulus
Male
Parathyroid Hormone
/ blood
Phosphates
/ blood
Quality Assurance, Health Care
Registries
Renal Dialysis
/ adverse effects
Retrospective Studies
Serum Albumin
/ metabolism
Urogenital Abnormalities
/ complications
Vesico-Ureteral Reflux
/ complications
Anaemia
CAKUT
Children
Diastolic hypertension
Glomerular disease
Hyperphosphatemia
Hypoalbuminemia
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
03
06
2018
accepted:
13
02
2019
revised:
08
02
2019
pubmed:
8
3
2019
medline:
3
6
2020
entrez:
8
3
2019
Statut:
ppublish
Résumé
Paediatric dialysis patients still suffer from high morbidity rates. To improve this, quality assurance programs like the German QiNKid (Quality in Nephrology for Children)-Registry have been developed. In our study, the significance of underlying renal disease on a range of clinical and laboratory parameters impacting morbidity and mortality was analysed. Our aim was to evaluate whether or not disease-specific dialysis strategies should be considered in planning dialysis for a patient. Inclusion criteria were defined as follows: (1) CAKUT (congenital anomalies of the kidney and urinary tract) or glomerular disease patient, (2) < 18 years of age, (3) haemodialysis or peritoneal dialysis patient. Only measurements obtained from day 90 to 365 after the date of the first dialysis in the registry were analysed. Laboratory (serum albumin, haemoglobin, ferritin, calcium, phosphate, parathyroid hormone) and clinical parameters (height, blood pressure) were analysed using mixed effects models accounting for the correlation of repeated measures in individual patients. The study cohort comprised n = 167 CAKUT and n = 55 glomerular disease patients. Glomerular disease patients had significantly higher odds of hypoalbuminemia (OR 13.90, 95% CI 1.35-159.99; p = 0.0274), anaemia (OR 3.31, 95% CI 1.22-9.13; p = 0.0197), hyperphosphatemia (OR 9.69, 95% CI 2.65-37.26; p = 0.0006) and diastolic hypertension (OR 3.38, 95% CI 1.20-9.79; p = 0.0212). Glomerular disease patients might require more intensive dialysis regimens. The evaluation of hydration status should be given more attention, since conditions differing between the cohorts can be linked to overhydration. The QiNKid-Registry allows monitoring of the quality of paediatric dialysis in a nationwide cohort.
Sections du résumé
BACKGROUND
Paediatric dialysis patients still suffer from high morbidity rates. To improve this, quality assurance programs like the German QiNKid (Quality in Nephrology for Children)-Registry have been developed. In our study, the significance of underlying renal disease on a range of clinical and laboratory parameters impacting morbidity and mortality was analysed. Our aim was to evaluate whether or not disease-specific dialysis strategies should be considered in planning dialysis for a patient.
METHODS
Inclusion criteria were defined as follows: (1) CAKUT (congenital anomalies of the kidney and urinary tract) or glomerular disease patient, (2) < 18 years of age, (3) haemodialysis or peritoneal dialysis patient. Only measurements obtained from day 90 to 365 after the date of the first dialysis in the registry were analysed. Laboratory (serum albumin, haemoglobin, ferritin, calcium, phosphate, parathyroid hormone) and clinical parameters (height, blood pressure) were analysed using mixed effects models accounting for the correlation of repeated measures in individual patients.
RESULTS
The study cohort comprised n = 167 CAKUT and n = 55 glomerular disease patients. Glomerular disease patients had significantly higher odds of hypoalbuminemia (OR 13.90, 95% CI 1.35-159.99; p = 0.0274), anaemia (OR 3.31, 95% CI 1.22-9.13; p = 0.0197), hyperphosphatemia (OR 9.69, 95% CI 2.65-37.26; p = 0.0006) and diastolic hypertension (OR 3.38, 95% CI 1.20-9.79; p = 0.0212).
CONCLUSIONS
Glomerular disease patients might require more intensive dialysis regimens. The evaluation of hydration status should be given more attention, since conditions differing between the cohorts can be linked to overhydration. The QiNKid-Registry allows monitoring of the quality of paediatric dialysis in a nationwide cohort.
Identifiants
pubmed: 30843113
doi: 10.1007/s00467-019-04218-6
pii: 10.1007/s00467-019-04218-6
doi:
Substances chimiques
Hemoglobins
0
Parathyroid Hormone
0
Phosphates
0
Serum Albumin
0
Ferritins
9007-73-2
Calcium
SY7Q814VUP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1229-1236Références
Chavers BM, Molony JT, Solid CA, Rheault MN, Collins AJ (2015) One-year mortality rates in US children with end-stage renal disease. Am J Nephrol 41:121–128. https://doi.org/10.1159/000380828
doi: 10.1159/000380828
pubmed: 25766310
pmcid: 4406829
Chesnaye N, Bonthuis M, Schaefer F, Groothoff JW, Verrina E, Heaf JG, Jankauskiene A, Lukosiene V, Molchanova EA, Mota C, Peco-Antic A, Ratsch IM, Bjerre A, Roussinov DL, Sukalo A, Topaloglu R, Van Hoeck K, Zagozdzon I, Jager KJ, Van Stralen KJ, ESPN/ERA-EDTA registry (2014) Demographics of paediatric renal replacement therapy in Europe: a report of the ESPN/ERA-EDTA registry. Pediatr Nephrol 29:2403–2410. https://doi.org/10.1007/s00467-014-2884-6
doi: 10.1007/s00467-014-2884-6
pubmed: 25039018
Chesnaye NC, Schaefer F, Groothoff JW, Bonthuis M, Reusz G, Heaf JG, Lewis M, Maurer E, Paripovic D, Zagozdzon I, van Stralen KJ, Jager KJ (2016) Mortality risk in European children with end-stage renal disease on dialysis. Kidney Int 89:1355–1362. https://doi.org/10.1016/j.kint.2016.02.016
doi: 10.1016/j.kint.2016.02.016
pubmed: 27165828
Bakkaloglu SA, Borzych D, Soo Ha I, Serdaroglu E, Buscher R, Salas P, Patel H, Drozdz D, Vondrak K, Watanabe A, Villagra J, Yavascan O, Valenzuela M, Gipson D, Ng KH, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network Registry (2011) Cardiac geometry in children receiving chronic peritoneal dialysis: findings from the International Pediatric Peritoneal Dialysis Network (IPPN) registry. Clin J Am Soc Nephrol 6:1926–1933. https://doi.org/10.2215/CJN.05990710
doi: 10.2215/CJN.05990710
pubmed: 21737855
pmcid: 3359542
Boehm M, Riesenhuber A, Winkelmayer WC, Arbeiter K, Mueller T, Aufricht C (2007) Early erythropoietin therapy is associated with improved growth in children with chronic kidney disease. Pediatr Nephrol 22:1189–1193. https://doi.org/10.1007/s00467-007-0472-8
doi: 10.1007/s00467-007-0472-8
pubmed: 17394020
Borzych-Duzalka D, Bilginer Y, Ha IS, Bak M, Rees L, Cano F, Munarriz RL, Chua A, Pesle S, Emre S, Urzykowska A, Quiroz L, Ruscasso JD, White C, Pape L, Ramela V, Printza N, Vogel A, Kuzmanovska D, Simkova E, Muller-Wiefel DE, Sander A, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network Registry (2013) Management of anemia in children receiving chronic peritoneal dialysis. J Am Soc Nephrol 24:665–676. https://doi.org/10.1681/ASN.2012050433
doi: 10.1681/ASN.2012050433
pubmed: 23471197
pmcid: 3609132
Rosenkranz J, Reichwald-Klugger E, Oh J, Turzer M, Mehls O, Schaefer F (2005) Psychosocial rehabilitation and satisfaction with life in adults with childhood-onset of end-stage renal disease. Pediatr Nephrol 20:1288–1294. https://doi.org/10.1007/s00467-005-1952-3
doi: 10.1007/s00467-005-1952-3
pubmed: 15942781
Shroff RC, Donald AE, Hiorns MP, Watson A, Feather S, Milford D, Ellins EA, Storry C, Ridout D, Deanfield J, Rees L (2007) Mineral metabolism and vascular damage in children on dialysis. J Am Soc Nephrol 18:2996–3003. https://doi.org/10.1681/ASN.2006121397
doi: 10.1681/ASN.2006121397
pubmed: 17942964
Srivaths P, Krishnamurthy R, Brunner L, Logan B, Bennett M, Ma Q, VanDeVoorde R, Goldstein SL (2014) Cardiac calcifications are more prevalent in children receiving hemodialysis than peritoneal dialysis. Clin Nephrol 81:231–237
doi: 10.5414/CN108178
pubmed: 24656313
Cetin N, Sav NM, Karabel D, Yildirim A, Yildiz B (2016) Serum albumin and von Willebrand factor: possible markers for early detection of vascular damage in children undergoing peritoneal dialysis. Clin Invest Med 39:E111–E119
doi: 10.25011/cim.v39i4.27090
pubmed: 27619398
Tsai HL, Yang LY, Chin TW, Wang HH, Liu CS, Wei CF, Chang JW (2010) Outcome and risk factors for mortality in pediatric peritoneal dialysis. Perit Dial Int 30:233–239. https://doi.org/10.3747/pdi.2008.00278
doi: 10.3747/pdi.2008.00278
pubmed: 20150582
Amaral S, Hwang W, Fivush B, Neu A, Frankenfield D, Furth S (2006) Association of mortality and hospitalization with achievement of adult hemoglobin targets in adolescents maintained on hemodialysis. J Am Soc Nephrol 17:2878–2885. https://doi.org/10.1681/ASN.2005111215
doi: 10.1681/ASN.2005111215
pubmed: 16943308
Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629. https://doi.org/10.1046/j.1523-1755.2002.00156.x
doi: 10.1046/j.1523-1755.2002.00156.x
pubmed: 11849405
Furth SL, Hwang W, Yang C, Neu AM, Fivush BA, Powe NR (2002) Growth failure, risk of hospitalization and death for children with end-stage renal disease. Pediatr Nephrol 17:450–455. https://doi.org/10.1007/s00467-002-0838-x
doi: 10.1007/s00467-002-0838-x
pubmed: 12107811
Gesellschaft für Pädiatrische Nephrologie eV (2013) GP-Nephrologie Gesellschaft für Pädiatrische Nephrologie Kinderdialysezentren in Deutschland. http://www.gpnephrologie.de/zentren.html . Accessed 05.09. 2017
Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, Invitti C, Litwin M, Mancia G, Pall D, Rascher W, Redon J, Schaefer F, Seeman T, Sinha M, Stabouli S, Webb NJ, Wuhl E, Zanchetti A (2016) 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens 34:1887–1920. https://doi.org/10.1097/HJH.0000000000001039
doi: 10.1097/HJH.0000000000001039
pubmed: 27467768
WHO Multicentre Growth Reference Study Group (2006) WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development.Geneva: World Health Organization, 2006
Tentori F, Blayney MJ, Albert JM, Gillespie BW, Kerr PG, Bommer J, Young EW, Akizawa T, Akiba T, Pisoni RL, Robinson BM, Port FK (2008) Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 52:519–530. https://doi.org/10.1053/j.ajkd.2008.03.020
doi: 10.1053/j.ajkd.2008.03.020
pubmed: 18514987
Zyga S, Christopoulou G, Malliarou M (2011) Malnutrition-inflammation-atherosclerosis syndrome in patients with end-stage renal disease. J Ren Care 37:12–15. https://doi.org/10.1111/j.1755-6686.2011.00201.x
doi: 10.1111/j.1755-6686.2011.00201.x
pubmed: 21288312
Canpolat N, Caliskan S, Sever L, Tasdemir M, Ekmekci OB, Pehlivan G, Shroff R (2013) Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis. Pediatr Nephrol 28:2149–2156. https://doi.org/10.1007/s00467-013-2527-3
doi: 10.1007/s00467-013-2527-3
pubmed: 23765444
Garcia-Bello JA, Ortiz-Flores J, Torres de la Riva FE, Mendoza-Moreno GK, Gomez-Tenorio C (2018) Anemia and hypoalbuminemia as risk factors for left ventricular diastolic dysfunction in children with chronic kidney disease on peritoneal dialysis. Nefrologia 38:414–419. https://doi.org/10.1016/j.nefro.2017.11.024
doi: 10.1016/j.nefro.2017.11.024
pubmed: 30032857
John B, Tan BK, Dainty S, Spanel P, Smith D, Davies SJ (2010) Plasma volume, albumin, and fluid status in peritoneal dialysis patients. Clin J Am Soc Nephrol 5:1463–1470. https://doi.org/10.2215/cjn.09411209
doi: 10.2215/CJN.09411209
pubmed: 20538836
pmcid: 2924416
Bakkaloglu SA, Kandur Y, Serdaroglu E, Noyan A, Bayazit AK, Tasdemir M, Ozlu SG, Ozcelik G, Dursun I, Alparslan C, Akcaboy M, Atikel YO, Parmaksiz G, Atmis B, Sever L (2018) Time-averaged hemoglobin values, not hemoglobin cycling, have an impact on outcomes in pediatric dialysis patients. Pediatr Nephrol 33:2143–2150. https://doi.org/10.1007/s00467-018-4013-4
doi: 10.1007/s00467-018-4013-4
pubmed: 30105415
Warady BA, Ho M (2003) Morbidity and mortality in children with anemia at initiation of dialysis. Pediatr Nephrol 18:1055–1062. https://doi.org/10.1007/s00467-003-1214-1
doi: 10.1007/s00467-003-1214-1
pubmed: 12883982
Atkinson MA, Martz K, Warady BA, Neu AM (2010) Risk for anemia in pediatric chronic kidney disease patients: a report of NAPRTCS. Pediatr Nephrol 25:1699–1706. https://doi.org/10.1007/s00467-010-1538-6
doi: 10.1007/s00467-010-1538-6
pubmed: 20464428
Lestz RM, Atkinson M, Fivush B, Furth SL (2011) No difference in meeting hemoglobin and albumin targets for dialyzed children with urologic disorders. Pediatr Nephrol 26:1129–1136. https://doi.org/10.1007/s00467-011-1850-9
doi: 10.1007/s00467-011-1850-9
pubmed: 21424524
pmcid: 5739035
Borzych D, Rees L, Ha IS, Chua A, Valles PG, Lipka M, Zambrano P, Ahlenstiel T, Bakkaloglu SA, Spizzirri AP, Lopez L, Ozaltin F, Printza N, Hari P, Klaus G, Bak M, Vogel A, Ariceta G, Yap HK, Warady BA, Schaefer F, International Pediatric PD Network (IPPN) (2010) The bone and mineral disorder of children undergoing chronic peritoneal dialysis. Kidney Int 78:1295–1304. https://doi.org/10.1038/ki.2010.316
doi: 10.1038/ki.2010.316
pubmed: 20811335
Schmidt BMW, Sugianto RI, Thurn D, Azukaitis K, Bayazit AK, Canpolat N, Eroglu AG, Caliskan S, Doyon A, Duzova A, Karagoz T, Anarat A, Deveci M, Mir S, Ranchin B, Shroff R, Baskin E, Litwin M, Ozcakar ZB, Buscher R, Soylemezoglu O, Dusek J, Kemper MJ, Matteucci MC, Habbig S, Laube G, Wuhl E, Querfeld U, Sander A, Schaefer F, Melk A (2018) Early effects of renal replacement therapy on cardiovascular comorbidity in children with end-stage kidney disease: findings from the 4C-T study. Transplantation 102:484–492. https://doi.org/10.1097/tp.0000000000001948
doi: 10.1097/tp.0000000000001948
pubmed: 28926375
Civilibal M, Caliskan S, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Bugra Z, Arisoy N (2007) Traditional and “new” cardiovascular risk markers and factors in pediatric dialysis patients. Pediatr Nephrol 22:1021–1029. https://doi.org/10.1007/s00467-007-0451-0
doi: 10.1007/s00467-007-0451-0
pubmed: 17340147
Al-Biltagi M, ElHafez MAA, El Amrousy DM, El-Gamasy M, El-Serogy H (2017) Evaluation of the coronary circulation and calcification in children on regular hemodialysis. Pediatr Nephrol 32:1941–1951. https://doi.org/10.1007/s00467-017-3678-4
doi: 10.1007/s00467-017-3678-4
pubmed: 28497191
Tkaczyk M, Stanczyk M, Miklaszewska M, Zachwieja K, Wiercinski R, Stankiewicz R, Firszt-Adamczyk A, Zachwieja J, Borzecka H, Zagozdzon I, Leszczynska B, Medynska A, Adamczyk P, Szczepanska M, Fendler W (2017) What has changed in the prevalence of hypertension in dialyzed children during the last decade? Ren Fail 39:283–289. https://doi.org/10.1080/0886022x.2016.1260033
doi: 10.1080/0886022X.2016.1260033
pubmed: 27882810
Halbach SM, Martz K, Mattoo T, Flynn J (2012) Predictors of blood pressure and its control in pediatric patients receiving dialysis. J Pediatr 160:621–625 e621. https://doi.org/10.1016/j.jpeds.2011.09.046
doi: 10.1016/j.jpeds.2011.09.046
pubmed: 22056352
Ha IS, Yap HK, Munarriz RL, Zambrano PH, Flynn JT, Bilge I, Szczepanska M, Lai WM, Antonio ZL, Gulati A, Hooman N, van Hoeck K, Higuita LM, Verrina E, Klaus G, Fischbach M, Riyami MA, Sahpazova E, Sander A, Warady BA, Schaefer F (2015) Risk factors for loss of residual renal function in children treated with chronic peritoneal dialysis. Kidney Int 88:605–613. https://doi.org/10.1038/ki.2015.108
doi: 10.1038/ki.2015.108
pubmed: 25874598
pmcid: 4558567
Thumfart J, Hilliger T, Stiny C, Wagner S, Querfeld U, Muller D (2015) Is peritoneal dialysis still an equal option? Results of the Berlin pediatric nocturnal dialysis program. Pediatr Nephrol 30:1181–1187. https://doi.org/10.1007/s00467-015-3043-4
doi: 10.1007/s00467-015-3043-4
pubmed: 25877914
Ayus JC, Achinger SG, Mizani MR, Chertow GM, Furmaga W, Lee S, Rodriguez F (2007) Phosphorus balance and mineral metabolism with 3 h daily hemodialysis. Kidney Int 71:336–342. https://doi.org/10.1038/sj.ki.5002044
doi: 10.1038/sj.ki.5002044
pubmed: 17191084
Fischbach M, Terzic J, Menouer S, Dheu C, Soskin S, Helmstetter A, Burger MC (2006) Intensified and daily hemodialysis in children might improve statural growth. Pediatr Nephrol 21:1746–1752. https://doi.org/10.1007/s00467-006-0226-z
doi: 10.1007/s00467-006-0226-z
pubmed: 16941145
Ting GO, Kjellstrand C, Freitas T, Carrie BJ, Zarghamee S (2003) Long-term study of high-comorbidity ESRD patients converted from conventional to short daily hemodialysis. Am J Kidney Dis 42:1020–1035
doi: 10.1016/j.ajkd.2003.07.020
pubmed: 14582046