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No difference in meeting hemoglobin and albumin targets for dialyzed children with urologic disorders

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Abstract

Urologic disorders are the most common cause of chronic kidney disease in children. To determine whether children with urologic etiology of end-stage renal disease (ESRD) fare better than children with ESRD from other causes while on dialysis, we conducted a cross-sectional study of children <18 years receiving peritoneal and hemodialysis in the United States using data from the Centers for Medicare & Medicaid Services 2005 ESRD CPM Project. We compared baseline demographics and the study groups. In multivariate logistic regression analysis of 1,286 subjects, we assessed whether children with urologic disorders had a higher odds of meeting adult KDOQI targets for hemoglobin levels ≥11 g/dl and albumin ≥3.5 BCG/3.2 BCP g/dl. We conducted a subset analysis of 1,136 patients to examine the impact of erythropoietin on hemoglobin targets. Our results did not reveal differences in achievement of adult hemoglobin targets (adjusted OR: 1.27; p value 0.09; CI: 0.97–1.66) or in the subset analysis with erythropoietin (adjusted OR: 1.32; p value 0.06; CI: 0.98–1.78) or albumin targets (adjusted OR: 1.22; p value 0.21; CI: 0.90–1.65) in adjusted analyses. Due to our study’s limitations, it is difficult to determine whether this may result from treatment prior to dialysis initiation or treatment effect of dialysis rather than underlying diagnosis.

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References

  1. Wiesel A, Queisser-Luft A, Clementi M, Bianca S, Stoll C (2005) Prenatal detection of congenital renal malformations by fetal ultrasonographic examination: an analysis of 709,030 births in 12 European countries. Eur J Med Genet 48:131–144

    Article  CAS  Google Scholar 

  2. NAPRTCS (2008) Annual Report. In: DM MKaS (ed) The Emmes Corporation, Rockville, MD

  3. Geary DFSF (2008) Comprehensive Pediatric Nephrology. Mosby, Philadelphia, PA

    Google Scholar 

  4. Neild GH (2009) What do we know about chronic renal failure in young adults? II. Adult outcome of pediatric renal disease. Pediatr Nephrol 24:1921–1928

    Article  Google Scholar 

  5. Wuhl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Moller K, Wigger M, Peruzzi L, Mehls O, Schaefer F (2009) Strict blood-pressure control and progression of renal failure in children. N Engl J Med 361:1639–1650

    Article  Google Scholar 

  6. Amaral S, Hwang W, Fivush B, Neu A, Frankenfield D, Furth S (2008) Serum albumin level and risk for mortality and hospitalization in adolescents on hemodialysis. Clin J Am Soc Nephrol 3:759–767

    Article  CAS  Google Scholar 

  7. Amaral S, Hwang W, Fivush B, Neu A, Frankenfield D, Furth S (2006) Association of mortality and hospitalization with achievement of adult hemoglobin targets in adolescents maintained on hemodialysis. J Am Soc Nephrol 17:2878–2885

    Article  Google Scholar 

  8. Warady BA, Ho M (2003) Morbidity and mortality in children with anemia at initiation of dialysis. Pediatr Nephrol 18:1055–1062

    Article  Google Scholar 

  9. Frankenfield DL, Neu AM, Warady BA, Fivush BA, Johnson CA, Brem AS (2003) Anemia in pediatric hemodialysis patients: results from the 2001 ESRD Clinical Performance Measures Project. Kidney Int 64:1120–1124

    Article  Google Scholar 

  10. Centers for Medicare & Medicaid Services (2005) Annual Report, End Stage Renal Disease Clinical Peformance Measures Project. Am J Kidney Dis 48: S1-S106, 2006 (suppl 2)

  11. KDOQI (2007) Clinical Practice Guideline and Clinical Practice Recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target. Am J Kidney Dis 50:471–530

    Article  Google Scholar 

  12. Kalantar-Zadeh K, Stenvinkel P, Pillon L, Kopple JD (2003) Inflammation and nutrition in renal insufficiency. Adv Ren Replace Ther 10:155–169

    Article  Google Scholar 

  13. Daiguadas JTBP, Ing TS (2007) Handbook of Dialysis Fourth Edition. Lippincott Williams & Wilkins, Philadelphia, PA

  14. Warady B (2004) Care of the pediatric patient on peritoneal dialysis: clinical process for optimal outcomes. In: Schaefer F (ed) Baxter Healthcare Corp

  15. Morgenstern BZ, Wuhl E, Nair KS, Warady BA, Schaefer F (2006) Anthropometric prediction of total body water in children who are on pediatric peritoneal dialysis. J Am Soc Nephrol 17:285–293

    Article  Google Scholar 

  16. K/DOQI (2006) Clinical practice guidelines for peritoneal dialysis adequacy. Am J Kidney Dis 2006:S1

  17. Owen WF Jr, Lew NL, Liu Y, Lowrie EG, Lazarus JM (1993) The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 329:1001–1006

    Article  Google Scholar 

  18. JaLS HDW (2000) Applied Logistic Regression. John Wiley & Sons, New York

    Google Scholar 

  19. Warady BA, Chadha V (2007) Chronic kidney disease in children: the global perspective. Pediatr Nephrol 22:1999–2009

    Article  Google Scholar 

  20. Soares CM, Diniz JS, Lima EM, Silva JM, Oliveira GR, Canhestro MR, Colosimo EA, Simoes e Silva AC, Oliveira EA (2008) Clinical outcome of children with chronic kidney disease in a pre-dialysis interdisciplinary program. Pediatr Nephrol 23:2039–2046

    Article  Google Scholar 

  21. Gillen DL, Stehman-Breen CO, Smith JM, McDonald RA, Warady BA, Brandt JR, Wong CS (2008) Survival advantage of pediatric recipients of a first kidney transplant among children awaiting kidney transplantation. Am J Transplant 8:2600–2606

    Article  CAS  Google Scholar 

  22. Fadrowski JJ, Hwang W, Frankenfield DL, Fivush BA, Neu AM, Furth SL (2006) Clinical course associated with vascular access type in a national cohort of adolescents who receive hemodialysis: findings from the Clinical Performance Measures and US Renal Data System projects. Clin J Am Soc Nephrol 1:987–992

    Article  Google Scholar 

  23. Port RE, Mehls O (1999) Erythropoietin dosing in children with chronic kidney disease: based on body size or hemoglobin deficit? Pediatr Nephrol:435–437

  24. Chavers BM, Roberts TL, Herzog CA, Collins AJ, St Peter WL (2004) Prevalence of anemia in erythropoietin-treated pediatric as compared to adult chronic dialysis patients. Kidney Int 65:266–273

    Article  CAS  Google Scholar 

  25. Bamgbola OF, Kaskel FJ, Coco M (2009) Analyses of age, gender and other risk factors of erythropoietin resistance in pediatric and adult dialysis cohorts. Pediatr Nephrol 24:571–579

    Article  Google Scholar 

  26. Diaz-Buxo JA, Lowrie EG, Lew NL, Zhang SM, Zhu X, Lazarus JM (1999) Associates of mortality among peritoneal dialysis patients with special reference to peritoneal transport rates and solute clearance. Am J Kidney Dis 33:523–534

    Article  CAS  Google Scholar 

  27. Termorshuizen F, Korevaar JC, Dekker FW, van Manen JG, Boeschoten EW, Krediet RT (2003) The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD )-2. Am J Kidney Dis 41:1293–1302

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Johns Hopkins University, 200 N. Wolfe St., Baltimore, MD, 21287, USA

    Rachel M. Lestz, Meredith Atkinson & Barbara Fivush

  2. Division of Pediatric Nephrology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan L. Furth

Authors
  1. Rachel M. Lestz
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  2. Meredith Atkinson
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  3. Barbara Fivush
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  4. Susan L. Furth
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Correspondence to Rachel M. Lestz.

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Lestz, R.M., Atkinson, M., Fivush, B. et al. No difference in meeting hemoglobin and albumin targets for dialyzed children with urologic disorders. Pediatr Nephrol 26, 1129–1136 (2011). https://doi.org/10.1007/s00467-011-1850-9

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  • DOI: https://doi.org/10.1007/s00467-011-1850-9

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