Skip to main content
Log in

Effect of center practices on the choice of the first dialysis modality for children and young adults

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Peritoneal dialysis (PD) remains the modality of choice in children, but there is no clear evidence to support a better outcome in children treated with PD. We aimed to assess factors that have an impact on the choice of dialysis modality in children and young adults in France and sought to determine the roles of medical factors and center practices.

Methods

We included all patients aged <20 years at the start of renal replacement therapy (RRT), recorded in the French RRT Registry between 2002 and 2013. Hierarchical logistic regression models were used to study the association between the patient/center characteristics and the probability of receiving PD as the first dialysis modality.

Results

We included 806 patients starting RRT in 177 centers, 23 of which were specialized pediatric centers. Six hundred and one patients (74.6 %) started with hemodialysis (HD), whereas 205 (25.4 %) started with PD. A greater probability of PD was found in younger children, whereas starting the treatment in an emergency setting was associated with a low use of PD. We found a significant variability among centers that accounted for 43 % of the total variability. The probability of PD was higher in adult centers and was proportional to the rate of PD in the center.

Conclusions

Center practices are a major factor in the choice of dialysis modality. This raises concerns about patient and family choices and to what extent doctors may influence the final decision. Further pediatric studies focusing on children’s and parents’ wishes are needed to provide care as close as possible to patients’ and families’ expectations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Khawar O, Kalantar-Zadeh K, Lo WK, Johnson D, Mehrotra R (2007) Is the declining use of long-term peritoneal dialysis justified by outcome data? Clin J Am Soc Nephrol 2:1317–1328

    Article  PubMed  Google Scholar 

  2. Vonesh EF, Snyder JJ, Foley RN, Collins AJ (2006) Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us? Kidney Int Suppl 103:S3–S11

    Article  Google Scholar 

  3. Quinn RR, Hux JE, Oliver MJ, Austin PC, Tonelli M, Laupacis A (2011) Selection bias explains apparent differential mortality between dialysis modalities. J Am Soc Nephrol 22:1534–1542

    Article  PubMed  PubMed Central  Google Scholar 

  4. Yeates K, Zhu N, Vonesh E, Trpeski L, Blake P, Fenton S (2012) Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transplant 27:3568–3575

    Article  PubMed  Google Scholar 

  5. Kumar VA, Sidell MA, Jones JP, Vonesh EF (2014) Survival of propensity matched incident peritoneal and hemodialysis patients in a United States health care system. Kidney Int 86:1016–1022

    Article  PubMed  Google Scholar 

  6. Molnar MZ, Mehrotra R, Duong U, Bunnapradist S, Lukowsky LR, Krishnan M, Kovesdy CP, Kalantar-Zadeh K (2012) Dialysis modality and outcomes in kidney transplant recipients. Clin J Am Soc Nephrol 7:332–341

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Chalem Y, Ryckelynck JP, Tuppin P, Verger C, Chauve S, Glotz D (2005) Access to, and outcome of, renal transplantation according to treatment modality of end-stage renal disease in France. Kidney Int 67:2448–2453

    Article  PubMed  Google Scholar 

  8. Jaar BG (2011) The Achilles heel of mortality risk by dialysis modality is selection bias. J Am Soc Nephrol 22:1398–1400

    Article  PubMed  Google Scholar 

  9. Mehrotra R (2011) Choice of dialysis modality. Kidney Int 80:909–911

    Article  PubMed  Google Scholar 

  10. Maaroufi A, Fafin C, Mougel S, Favre G, Seitz-Polski B, Jeribi A, Vido S, Dewisme C, Albano L, Esnault V, Moranne O (2013) Patients’ preferences regarding choice of end-stage renal disease treatment options. Am J Nephrol 37:359–369

    Article  CAS  PubMed  Google Scholar 

  11. Jager KJ, Korevaar JC, Dekker FW, Krediet RT, Boeschoten EW (2004) The effect of contraindications and patient preference on dialysis modality selection in ESRD patients in The Netherlands. Am J Kidney Dis 43:891–899

    Article  PubMed  Google Scholar 

  12. Feber J, Scharer K, Schaefer F, Mikova M, Janda J (1994) Residual renal function in children on haemodialysis and peritoneal dialysis therapy. Pediatr Nephrol 8:579–583

    Article  CAS  PubMed  Google Scholar 

  13. McDonald SP, Craig JC (2004) Long-term survival of children with end-stage renal disease. N Engl J Med 350:2654–2662

    Article  CAS  PubMed  Google Scholar 

  14. Wong CS, Hingorani S, Gillen DL, Sherrard DJ, Watkins SL, Brandt JR, Ball A, Stehman-Breen CO (2002) Hypoalbuminemia and risk of death in pediatric patients with end-stage renal disease. Kidney Int 61:630–637

    Article  PubMed  Google Scholar 

  15. Mitsnefes MM, Laskin BL, Dahhou M, Zhang X, Foster BJ (2013) Mortality risk among children initially treated with dialysis for end-stage kidney disease, 1990–2010. JAMA 309:1921–1929

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Vidal E, Van Stralen KJ, Schaefer F, Adams B, Bjerre A, Dusunse R, Emirova KM, Esteves Da Silva JE, Herthelius M, Holmberg C, Jankauskiene A, Mache CJ, Miteva P, Sanchez-Moreno A, Antonella Trivelli A, Aleksandra Zurowska A, Groothoff JW, Jager K, Verrina E (2014) Clinical characteristics and outcomes of infants on chronic dialysis. Nephrol Dial Transplant 29 [Suppl 3]:iii7–iii8

    Article  Google Scholar 

  17. Ronco C, Garzotto F, Brendolan A, Zanella M, Bellettato M, Vedovato S, Chiarenza F, Ricci Z, Goldstein SL (2014) Continuous renal replacement therapy in neonates and small infants: development and first-in-human use of a miniaturised machine (CARPEDIEM). Lancet 383:1807–1813

    Article  PubMed  Google Scholar 

  18. Coulthard MG, Crosier J, Griffiths C, Smith J, Drinnan M, Whitaker M, Beckwith R, Matthews JN, Flecknell P, Lambert HJ (2014) Haemodialysing babies weighing <8 kg with the Newcastle infant dialysis and ultrafiltration system (Nidus): comparison with peritoneal and conventional haemodialysis. Pediatr Nephrol 29:1873–1881

    Article  PubMed  PubMed Central  Google Scholar 

  19. Conseil d’état (2002) Décret n° 2002–1197 du 23 septembre 2002 relatif à l’activité de traitement de l’insuffisance rénale chronique par la pratique de l’épuration extrarénale et modifiant le code de la santé publique. Journal officiel, vol Article R. 712–796

  20. Phirtskhalaishvili T, Bayer F, Edet S, Bongiovanni I, Hogan J, Couchoud C (2016) Spatial analysis of case-mix and dialysis modality associations. Perit Dial Int 36:326–333

    Article  PubMed  Google Scholar 

  21. Couchoud C, Stengel B, Landais P, Aldigier JC, de Cornelissen F, Dabot C, Maheut H, Joyeux V, Kessler M, Labeeuw M, Isnard H, Jacquelinet C (2006) The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France. Nephrol Dial Transplant 21:411–418

    Article  PubMed  Google Scholar 

  22. ARGIS www.arcgis.com

  23. Rubin DB, Schenker N (1991) Multiple imputation in health-care databases: an overview and some applications. Stat Med 10:585–598

    Article  CAS  PubMed  Google Scholar 

  24. Diez-Roux AV (2000) Multilevel analysis in public health research. Annu Rev Public Health 21:171–192

    Article  CAS  PubMed  Google Scholar 

  25. Leonard MB, Donaldson LA, Ho M, Geary DF (2003) A prospective cohort study of incident maintenance dialysis in children: an NAPRTC study. Kidney Int 63:744–755

    Article  PubMed  Google Scholar 

  26. Watson AR, Hayes WN, Vondrak K, Ariceta G, Schmitt CP, Ekim M, Fischbach M, Edefonti A, Shroff R, Holta T, Zurowska A, Klaus G, Bakkaloglu S, Stefanidis CJ, Van de Walle J (2013) Factors influencing choice of renal replacement therapy in European paediatric nephrology units. Pediatr Nephrol 28:2361–2368

    Article  PubMed  Google Scholar 

  27. Smart NA, Titus TT (2011) Outcomes of early versus late nephrology referral in chronic kidney disease: a systematic review. Am J Med 124:1073–1080

    Article  PubMed  Google Scholar 

  28. Cullis B, Abdelraheem M, Abrahams G, Balbi A, Cruz DN, Frishberg Y, Koch V, McCulloch M, Numanoglu A, Nourse P, Pecoits-Filho R, Ponce D, Warady B, Yeates K, Finkelstein FO (2014) Peritoneal dialysis for acute kidney injury. Perit Dial Int 34:494–517

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Bunchman TE, McBryde KD, Mottes TE, Gardner JJ, Maxvold NJ, Brophy PD (2001) Pediatric acute renal failure: outcome by modality and disease. Pediatr Nephrol 16:1067–1071

    Article  CAS  PubMed  Google Scholar 

  30. Flynn JT, Kershaw DB, Smoyer WE, Brophy PD, McBryde KD, Bunchman TE (2001) Peritoneal dialysis for management of pediatric acute renal failure. Perit Dial Int 21:390–394

    CAS  PubMed  Google Scholar 

  31. Prakash S, Coffin R, Schold J, Lewis SA, Gunzler D, Stark S, Howard M, Rodgers D, Einstadter D, Sehgal AR (2014) Travel distance and home dialysis rates in the United States. Perit Dial Int 34:24–32

    Article  PubMed  PubMed Central  Google Scholar 

  32. Shen JI, Mitani AA, Saxena AB, Goldstein BA, Winkelmayer WC (2013) Determinants of peritoneal dialysis technique failure in incident US patients. Perit Dial Int 33:155–166

    Article  PubMed  PubMed Central  Google Scholar 

  33. Grace BS, Clayton PA, Gray NA, McDonald SP (2014) Socioeconomic differences in the uptake of home dialysis. Clin J Am Soc Nephrol 9:929–935

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mahajan S, Tiwari SC, Kalra V, Bhowmik DM, Agarwal SK (2004) Factors affecting the use of peritoneal dialysis among the ESRD population in India: a single-center study. Perit Dial Int 24:538–541

    PubMed  Google Scholar 

  35. Castrale C, Evans D, Verger C, Fabre E, Aguilera D, Ryckelynck JP, Lobbedez T (2010) Peritoneal dialysis in elderly patients: report from the French Peritoneal Dialysis Registry (RDPLF). Nephrol Dial Transplant 25:255–262

    Article  PubMed  Google Scholar 

  36. Furth SL, Powe NR, Hwang W, Neu AM, Fivush BA (1997) Does greater pediatric experience influence treatment choices in chronic disease management? Dialysis modality choice for children with end-stage renal disease. Arch Pediatr Adolesc Med 151:545–550

    Article  CAS  PubMed  Google Scholar 

  37. Tromp WF, Schoenmaker NJ, van der Lee JH, Adams B, Bouts AH, Collard L, Cransberg K, Van Damme-Lombaerts R, Godefroid N, van Hoeck K, Koster-Kamphuis L, Lilien MR, Raes A, Offringa M, Groothoff JW (2012) Important differences in management policies for children with end-stage renal disease in the Netherlands and Belgium—report from the RICH-Q study. Nephrol Dial Transplant 27:1984–1992

    Article  PubMed  Google Scholar 

  38. Bouvier N, Durand PY, Testa A, Albert C, Planquois V, Ryckelynck JP, Lobbedez T (2009) Regional discrepancies in peritoneal dialysis utilization in France: the role of the nephrologist’s opinion about peritoneal dialysis. Nephrol Dial Transplant 24:1293–1297

    Article  PubMed  Google Scholar 

  39. UK Renal Registry (2013) The Sixteenth Annual Report.

  40. Harambat J, Hogan J, Macher MA, Couchoud C, Registre du REIN (2013) ESRD in children and adolescents. Nephrol Ther 9 [Suppl 1]:S167–S179

    Article  PubMed  Google Scholar 

  41. Little J, Irwin A, Marshall T, Rayner H, Smith S (2001) Predicting a patient’s choice of dialysis modality: experience in a United Kingdom renal department. Am J Kidney Dis 37:981–986

    Article  CAS  PubMed  Google Scholar 

  42. Chanouzas D, Ng KP, Fallouh B, Baharani J (2012) What influences patient choice of treatment modality at the pre-dialysis stage? Nephrol Dial Transplant 27:1542–1547

    Article  PubMed  Google Scholar 

  43. Wuerth DB, Finkelstein SH, Schwetz O, Carey H, Kliger AS, Finkelstein FO (2002) Patients’ descriptions of specific factors leading to modality selection of chronic peritoneal dialysis or hemodialysis. Perit Dial Int 22:184–190

    PubMed  Google Scholar 

  44. McKenna AM, Keating LE, Vigneux A, Stevens S, Williams A, Geary DF (2006) Quality of life in children with chronic kidney disease-patient and caregiver assessments. Nephrol Dial Transplant 21:1899–1905

    Article  PubMed  Google Scholar 

  45. Lai WM (2009) Quality of life in children with end-stage renal disease: does treatment modality matter? Perit Dial Int 29 [Suppl 2]:S190–S191

    PubMed  Google Scholar 

  46. Lopes M, Ferraro A, Koch VH (2014) Health-related quality of life of children and adolescents with CKD stages 4–5 and their caregivers. Pediatr Nephrol 29:1239–1247

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Julien Hogan.

Ethics declarations

Funding

None.

Statement of competing financial interests

The authors declare that they have no competing interests.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 127 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hogan, J., Ranchin, B., Fila, M. et al. Effect of center practices on the choice of the first dialysis modality for children and young adults. Pediatr Nephrol 32, 659–667 (2017). https://doi.org/10.1007/s00467-016-3538-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-016-3538-7

Keywords

Navigation