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Pediatric Nephrology

, Volume 34, Issue 7, pp 1229–1236 | Cite as

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

  • Katrin Lübbe
  • Eva NüskenEmail author
  • Katherine Rascher
  • Gero von Gersdorff
  • Heyke Cramer
  • Christina Samel
  • Claudia Barth
  • Dieter Bach
  • Lutz T. Weber
  • Jörg Dötsch
Original Article
Part of the following topical collections:
  1. What's New in Dialysis

Abstract

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.

Keywords

Hypoalbuminemia Anaemia Hyperphosphatemia Diastolic hypertension CAKUT Glomerular disease Children 

Notes

Acknowledgements

We would like to thank the patients and staff of all German paediatric KfH centres for their support and data contribution. Our thanks go to Dominik Mueller (Berlin), Wolfgang Rascher (Erlangen), Rainer Buescher and Peter Hoyer (Essen), Matthias Hansen (Frankfurt), Martin Pohl (Freiburg), Jun Oh (Hamburg), Dieter Haffner and Lars Pape (Hannover), Franz Schaefer (Heidelberg), Ulrike John (Jena), Lutz Weber (Köln), Simone Wygoda (Leipzig), Guenter Klaus and Stefanie Weber (Marburg), Henry Fehrenbach (Memmingen), Carmen Montoya (München), Martin Konrad (Münster), and Hagen Staude (Rostock) representing the respective centres. We sincerely appreciate the constant commitment to this registry. In addition, we would like to thank Roswitha Breuer from the QiN-Registry for her ongoing efforts to ensure data entry in the QiNKid-Registry.

Compliance with ethical standards

Patient data in the QiNKid-Registry are collected automatically in an anonymous form after a declaration of consent has been signed by the legal guardian.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© IPNA 2019

Authors and Affiliations

  • Katrin Lübbe
    • 1
  • Eva Nüsken
    • 1
    Email author
  • Katherine Rascher
    • 2
  • Gero von Gersdorff
    • 2
  • Heyke Cramer
    • 2
  • Christina Samel
    • 3
  • Claudia Barth
    • 4
  • Dieter Bach
    • 4
  • Lutz T. Weber
    • 1
  • Jörg Dötsch
    • 1
  1. 1.Pediatric Nephrology, Department of PediatricsFaculty of Medicine and University Hospital Cologne, University of CologneCologneGermany
  2. 2.QiN-Group, Department of Medicine IIFaculty of Medicine and University Hospital Cologne, University of CologneCologneGermany
  3. 3.Institute of Medical Statistics, Informatics and EpidemiologyFaculty of Medicine and University Hospital Cologne, University of CologneCologneGermany
  4. 4.KfH-Curatorium for Dialysis and Kidney Transplantation e.V.Neu-IsenburgGermany

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