Weaver DJ, et al. - A comparative analysis of clinical parameters and patient survival in first 10 years of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) registry (1992–2001) vs. the last decade (2002–2011) demonstrated improvement in the survival of pediatric patients on chronic dialysis, over a duration of two decades of dialysis registry data. Furthermore, this was specifically noted for children <1year.

Methods

• In this study, clinical parameters and patient survival in the first 10 years of the registry (1992–2001) were compared with the last decade of the registry (2002–2011).

Results

• In the most recent cohort, a significant increase was observed in hemodialysis as the initiating dialysis modality (42% vs. 36%, p < 0.001).
• Researchers observed that there was a less likelihood to have a hemoglobin <10 g/dl [odds ratio (OR) 0.68; confidence interval (CI) 0.58–0.81; p < 0.001] and height z-score <2 standard deviations (SD) below average (OR 0.68, CI 0.59–0.78, p < 0.0001) in patients in the later cohort.
• Also, a parathyroid hormone (PTH) level two times above the upper limits of normal was more likely in them (OR 1.39, CI 1.21–1.60, p < 0.0001).
• Findings demonstrated that although hypertension was common regardless of era, blood pressure >90th percentile (OR 1.39, CI 1.21–1.60,p < 0.0001) was less likely in patients in the 2002–2011 group.
• In the 2002–2011 cohort versus in the 1992–2001 cohort, a significant improvement in survival at 36 months after dialysis initiation was observed (95% vs. 90%, respectively).
• In both cohorts, cardiopulmonary causes were identified as the most commonly reported cause of death.
• Poor predictors of survival were: young age, growth deficit, and black race.