Pediatric Nephrology

, Volume 24, Issue 9, pp 1719–1726

Frequency, etiology and treatment of childhood end-stage kidney disease in Australia and New Zealand

  • Nigel I. T. Orr
  • Stephen P. McDonald
  • Steven McTaggart
  • Paul Henning
  • Jonathan C. Craig
Original Article


To describe the trends in end-stage kidney disease (ESKD) in children in Australia and New Zealand over time and across different ages, we analyzed data from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). A total of 1,485 children aged less than 18 years received renal replacement therapy (RRT) during the period from 1963 to 2006, of which children 55.6% were male. The incidence of ESKD increased over the first two decades but has been stable at 8 per million since the mid-1980s. The prevalence of ESKD continues to increase in all age groups, especially among older children, and is currently 50 per million in those aged less than 18 years. The cause of ESKD over the entire cohort was one-third each for glomerulonephritis (32.5%), structural anomalies (hypoplasia/dysplasia, posterior urethral valves or reflux nephropathy, 35.8%), and cystic disease or other conditions (31.7%). Proportionately, glomerulonephritis is becoming less common. Overall, 50% of children were commenced on peritoneal dialysis as the initial RRT modality, 30% were started on hemodialysis, and 20% underwent transplantation pre-emptively. The proportion of children receiving transplants has not increased over time.


Pediatrics ANZDATA Renal replacement therapy Epidemiology Dialysis Renal transplantation 


  1. 1.
    van der Heijden BJ, van Dijk PC, Verrier-Jones K, Jager KJ, Briggs JD (2004) Renal replacement therapy in children: data from 12 registries in Europe. Pediatr Nephrol 19:213–221PubMedCrossRefGoogle Scholar
  2. 2.
    Esbjorner E, Berg U, Hansson S (1997) Epidemiology of chronic renal failure in children: a report from Sweden 1986–1994. Swedish Pediatric Nephrology Association. Pediatr Nephrol 11:438–442PubMedCrossRefGoogle Scholar
  3. 3.
    Miklovicova D, Cornelissen M, Cransberg K, Groothoff JW, Dedik L, Schroder CH (2005) Etiology and epidemiology of end-stage renal disease in Dutch children 1987–2001. Pediatr Nephrol 20:1136–1142PubMedCrossRefGoogle Scholar
  4. 4.
    US Renal Data System (2008) USRDS 2008 annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MDGoogle Scholar
  5. 5.
    North American Pediatric Renal Trials and Collaborative Studies (2008) NAPRTCS 2008 Annual ReportGoogle Scholar
  6. 6.
    Hattori S, Yosioka K, Honda M, Ito H, Japanese Society for Pediatric Nephrology (2002) The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol 17:456–461PubMedCrossRefGoogle Scholar
  7. 7.
    Australia and New Zealand Dialysis and Transplant Registry (2008) ANZDATA Registry Report 2007. McDonald S, Chang S, Excell L (eds) Adelaide, South AustraliaGoogle Scholar
  8. 8.
    McDonald SP, Craig JC, Australian and New Zealand Paediatric Nephrology Association (2004) Long-term survival of children with end-stage renal disease. N Engl J Med 350:2654–2662PubMedCrossRefGoogle Scholar
  9. 9.
    Craig JC, Irwig LM, Knight JF, Roy LP (2000) Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy? Pediatrics 105:1236–1241PubMedCrossRefGoogle Scholar
  10. 10.
    Li SQ, Cass A, Cunningham J (2003) Cause of death in patients with end-stage renal disease: assessing concordance of death certificates with registry reports. Aust N Z J Public Health 27:419–424PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2009

Authors and Affiliations

  • Nigel I. T. Orr
    • 1
    • 2
  • Stephen P. McDonald
    • 3
    • 4
    • 5
  • Steven McTaggart
    • 6
    • 7
  • Paul Henning
    • 8
  • Jonathan C. Craig
    • 1
    • 2
  1. 1.Department of NephrologyChildren’s Hospital at WestmeadSydneyAustralia
  2. 2.Faculty of Medicine and School of Public HealthUniversity of SydneySydneyAustralia
  3. 3.ANZDATA RegistryAdelaideAustralia
  4. 4.Renal UnitThe Queen Elizabeth HospitalAdelaideAustralia
  5. 5.Discipline of MedicineUniversity of AdelaideAdelaideAustralia
  6. 6.Queensland Child & Adolescent Renal ServiceBrisbaneAustralia
  7. 7.University of QueenslandBrisbaneAustralia
  8. 8.Renal UnitWomen’s and Children’s HospitalAdelaideAustralia

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