PubMed İndeksli Yayınlar Koleksiyonu

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    Kidney Transplantation in Small Children: Association Between Body Weight and Outcome-A Report From the ESPN/ERA-EDTA Registry
    (2022) Boehm, Michael; Bonthuis, Marjolein; Aufricht, Christoph; Battelino, Nina; Bjerre, Anna; Edvardsson, Vidar O.; Herthelius, Maria; Hubmann, Holger; Jahnukainen, Timo; de Jong, Huib; Laube, Guido F.; Mattozzi, Francesca; Molchanova, Elena A.; Munoz, Marina; Noyan, Aytul; Pape, Lars; Printza, Nikoleta; Reusz, George; Roussey, Gwenaelle; Rubik, Jacek; Spasojevic-Dimitrijeva, Brankica; Seeman, Tomas; Ware, Nicholas; Vidal, Enrico; Harambat, Jerome; Jager, Kitty J.; Groothoff, Jaap; 33795596
    Background. Many centers accept a minimum body weight of 10 kg as threshold for kidney transplantation (Tx) in children. As solid evidence for clinical outcomes in multinational studies is lacking, we evaluated practices and outcomes in European children weighing below 10 kg at Tx. Methods. Data were obtained from the European Society of Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry on all children who started kidney replacement therapy at <2.5 y of age and received a Tx between 2000 and 2016. Weight at Tx was categorized (<10 versus >= 10 kg) and Cox regression analysis was used to evaluate its association with graft survival. Results. One hundred of the 601 children received a Tx below a weight of 10 kg during the study period. Primary renal disease groups were equal, but Tx <10 kg patients had lower pre-Tx weight gain per year (0.2 versus 2.1 kg; P < 0.001) and had a higher preemptive Tx rate (23% versus 7%; P < 0.001). No differences were found for posttransplant estimated glomerular filtration rates trajectories (P = 0.23). The graft failure risk was higher in Tx <10 kg patients at 1 y (graft survival: 90% versus 95%; hazard ratio, 3.84; 95% confidence interval, 1.24-11.84), but not at 5 y (hazard ratio, 1.71; 95% confidence interval, 0.68-4.30). Conclusions. Despite a lower 1-y graft survival rate, graft function, and survival at 5 y were identical in Tx <10 kg patients when compared with Tx >= 10 kg patients. Our results suggest that early transplantation should be offered to a carefully selected group of patients weighing <10 kg.
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    Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study
    (2020) Aksoy, Gulsah Kaya; Ekim, Mesiha; Bakkaloglu, Sevcan A.; Coskun, Seda; Delibas, Ali; Conkar, Secil; Yilmaz, Dilek; Kara, Aslihan; Saygili, Seha K.; Buyukkaragoz, Bahar; Yildirim, Zeynep Y.; Comak, Elif; Gurgoze, Metin K.; Sever, Lale; Noyan, Aytul; Bayazit, Aysun K.; Dusunsel, Ruhan; 32728843; AAD-5713-2021
    Background Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related noninfectious complications and the predisposing factors. Methods Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated. Results A total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5-13.2) and 7.6 (IQR, 2.8-11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079-1.315, p = 0.001 and OR 1.580; 95% CI 0.660-0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%. Conclusions Peritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely.