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Association between timing of dialysis initiation and clinical outcomes in the paediatric population: an ESPN/ERA-EDTA registry study

dc.rights.licenseopenen_US
dc.contributor.authorPREKA, E.
dc.contributor.authorBONTHUIS, M.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHARAMBAT, Jerome
dc.contributor.authorJAGER, K. J.
dc.contributor.authorGROOTHOFF, J. W.
dc.contributor.authorBAIKO, S.
dc.contributor.authorBAYAZIT, A. K.
dc.contributor.authorBOEHM, M.
dc.contributor.authorCVETKOVIC, M.
dc.contributor.authorEDVARDSSON, V. O.
dc.contributor.authorFOMINA, S.
dc.contributor.authorHEAF, J. G.
dc.contributor.authorHOLTTA, T.
dc.contributor.authorKIS, E.
dc.contributor.authorKOLVEK, G.
dc.contributor.authorKOSTER-KAMPHUIS, L.
dc.contributor.authorMOLCHANOVA, E. A.
dc.contributor.authorMUNOZ, M.
dc.contributor.authorNETO, G.
dc.contributor.authorNOVLJAN, G.
dc.contributor.authorPRINTZA, N.
dc.contributor.authorSAHPAZOVA, E.
dc.contributor.authorSARTZ, L.
dc.contributor.authorSINHA, M. D.
dc.contributor.authorVIDAL, E.
dc.contributor.authorVONDRAK, K.
dc.contributor.authorVRILLON, I.
dc.contributor.authorWEBER, L. T.
dc.contributor.authorWEITZ, M.
dc.contributor.authorZAGOZDZON, I.
dc.contributor.authorSTEFANIDIS, C. J.
dc.contributor.authorBAKKALOGLU, S. A.
dc.date.accessioned2020-07-09T16:47:28Z
dc.date.available2020-07-09T16:47:28Z
dc.date.issued2019-11-01
dc.identifier.issn1460-2385 (Electronic) 0931-0509 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/10376
dc.description.abstractEnBACKGROUND: There is no consensus regarding the timing of dialysis therapy initiation for end-stage kidney disease (ESKD) in children. As studies investigating the association between timing of dialysis initiation and clinical outcomes are lacking, we aimed to study this relationship in a cohort of European children who started maintenance dialysis treatment. METHODS: We used data on 2963 children from 21 different countries included in the European Society of Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry who started renal replacement therapy before 18 years of age between 2000 and 2014. We compared two groups according to the estimated glomerular filtration rate (eGFR) at start: eGFR >/=8 mL/min/1.73 m2 (early starters) and eGFR <8 mL/min/1.73 m2 (late starters). The primary outcomes were patient survival and access to transplantation. Secondary outcomes were growth and cardiovascular risk factors. Sensitivity analyses were performed to account for selection- and lead time-bias. RESULTS: The median eGFR at the start of dialysis was 6.1 for late versus 10.5 mL/min/1.73 m2 for early starters. Early starters were older [median: 11.0, interquartile range (IQR): 5.7-14.5 versus 9.4, IQR: 2.6-14.1 years]. There were no differences observed between the two groups in mortality and access to transplantation at 1, 2 and 5 years of follow-up. One-year evolution of height standard deviation scores was similar among the groups, whereas hypertension was more prevalent among late initiators. Sensitivity analyses resulted in similar findings. CONCLUSIONS: We found no evidence for a clinically relevant benefit of early start of dialysis in children with ESKD. Presence of cardiovascular risk factors, such as high blood pressure, should be taken into account when deciding to initiate or postpone dialysis in children with ESKD, as this affects the survival.
dc.language.isoENen_US
dc.subject.enLEHA
dc.title.enAssociation between timing of dialysis initiation and clinical outcomes in the paediatric population: an ESPN/ERA-EDTA registry study
dc.title.alternativeNephrol Dial Transplanten_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ndt/gfz069en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed31038179en_US
bordeaux.journalNephrology Dialysis Transplantationen_US
bordeaux.page1932-1940en_US
bordeaux.volume34en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue11en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamLEHA_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03162605
hal.version1
hal.date.transferred2021-03-08T14:38:51Z
hal.exporttrue
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