Published online January 15, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. e468-e473 (doi:10.1542/peds.2006-1754)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Carey, W. A.
Right arrow Articles by Mathias, R. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Carey, W. A.
Right arrow Articles by Mathias, R. S.
Related Collections
Right arrow Genitourinary Tract

ARTICLE

Outcomes of Dialysis Initiated During the Neonatal Period for Treatment of End-Stage Renal Disease: A North American Pediatric Renal Trials and Collaborative Studies Special Analysis

William A. Carey, MDa, Lynya I. Talley, PhDb, Sally A. Sehring, MDa, Janet M. Jaskula, RNc and Robert S. Mathias, MDc

a Divisions of Neonatal-Perinatal Medicine
c Pediatric Nephrology, University of California San Francisco Children's Hospital, University of California, San Francisco, California
b EMMES Corporation, Rockville, Maryland

OBJECTIVE. We sought to determine the outcomes of initiating long-term dialysis of neonates and children aged >1 to 24 months with end-stage renal disease.

PATIENTS AND METHODS. By querying the North American Pediatric Renal Trials and Collaborative Studies database, we obtained information on 193 neonates (≤1 month of age) and 505 children (>1–24 months of age) with a presumptive diagnosis of end-stage renal disease who initiated long-term dialysis. Dialysis characteristics and likelihood of hospitalization were compared using the {chi}2 test, and duration of hospitalization was compared using the Wilcoxon 2-sample test. Product limit methods were implemented, and the log rank test was used to compare time-to-event analyses. Multivariate analyses were performed using Cox proportional hazards models.

RESULTS. Neonates with end-stage renal disease were more likely to receive peritoneal dialysis versus hemodialysis than older children with end-stage renal disease. Moreover, neonates who initiated dialysis during the first month of life were just as likely to terminate dialysis as were the older children. Rates of renal transplantation were significantly lower in the neonates compared with the older children, but neonates were more likely to recover function of the native kidney. Although neonates were more often hospitalized, their overall risk of mortality was similar to that observed in older children.

CONCLUSIONS. Neonates with a presumptive diagnosis of end-stage renal disease may initiate long-term dialysis during the first month of life with outcomes comparable to those of patients who initiate dialysis later in infancy.

Key Words: neonate • end-stage renal disease • dialysis • renal transplantation • survival

Abbreviations: ESRD—end-stage renal disease • NAPRTCS—North American Pediatric Renal Trials and Collaborative Studies • ARPKD—autosomal recessive polycystic kidney disease • CNS—congenital nephrotic syndrome • CI—confidence interval

Accepted Aug 14, 2006.




This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
S. Feinstein, C. Rinat, R. Becker-Cohen, E. Ben-Shalom, S. B. Schwartz, and Y. Frishberg
The outcome of chronic dialysis in infants and toddlers--advantages and drawbacks of haemodialysis
Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1336 - 1345.
[Abstract] [Full Text] [PDF]

Home page
 AAP Grand RoundsHome page
J. Sherbotie
Outcomes After Neonatal and Infant Dialysis
AAP Grand Rounds, June 1, 2007; 17(6): 66 - 66.
[Full Text] [PDF]