Back to Search Start Over

Prolonged respiratory disorder predicts adverse prognosis in infants with end-stage kidney disease.

Authors :
Sakai T
Murakami Y
Okuda Y
Hamada R
Hamasaki Y
Ishikura K
Hataya H
Honda M
Source :
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2016 Nov; Vol. 31 (11), pp. 2127-36. Date of Electronic Publication: 2016 Jun 07.
Publication Year :
2016

Abstract

Background: Among comorbidities, pulmonary hypoplasia (PH) is known as a significant risk factor for mortality in infants with end-stage kidney disease (ESKD). However, the final outcomes of infants with both ESKD and PH are still not well defined, as the diagnosis modality, and definition of PH severity remain ambiguous.<br />Methods: Children initiating peritoneal dialysis during infancy from 1990 to 2015 were followed until death, date of last contact, or the end of 2015. We examined the long-term outcome of children with congenital pulmonary disorders by studying infants with prolonged respiratory disorders of greater than 28 days duration after birth and evaluated risk factors for mortality.<br />Results: Forty-six children were followed (median follow-up, 9.23 years), and classified as children without (nā€‰=ā€‰38; Group A) or with (nā€‰=ā€‰8; Group B) a prolonged respiratory disorder. Overall actuarial 5 year survival rate in this cohort was 79.5 %. The survival curve in Group B showed a significant decline compared with Group A. Prolonged respiratory disorder was significantly associated with mortality by multivariate analysis (hazard ratio, 8.32).<br />Conclusions: Infants who initiate peritoneal dialysis complicated by prolonged respiratory disorders have increased adverse risk factors for mortality; therefore, withholding aggressive treatment should be considered.

Details

Language :
English
ISSN :
1432-198X
Volume :
31
Issue :
11
Database :
MEDLINE
Journal :
Pediatric nephrology (Berlin, Germany)
Publication Type :
Academic Journal
Accession number :
27271033
Full Text :
https://doi.org/10.1007/s00467-016-3430-5