Prolonged respiratory disorder predicts adverse prognosis in infants with end-stage kidney disease View Full Text


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Article Info

DATE

2016-06-07

AUTHORS

Tomoyuki Sakai, Yoshitaka Murakami, Yusuke Okuda, Riku Hamada, Yuko Hamasaki, Kenji Ishikura, Hiroshi Hataya, Masataka Honda

ABSTRACT

BackgroundAmong 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.MethodsChildren 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.ResultsForty-six children were followed (median follow-up, 9.23 years), and classified as children without (n = 38; Group A) or with (n = 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).ConclusionsInfants who initiate peritoneal dialysis complicated by prolonged respiratory disorders have increased adverse risk factors for mortality; therefore, withholding aggressive treatment should be considered. More... »

PAGES

2127-2136

References to SciGraph publications

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  • 2000-10. Towards guidelines for dialysis in children with end-stage renal disease in PEDIATRIC NEPHROLOGY
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    http://scigraph.springernature.com/pub.10.1007/s00467-016-3430-5

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    http://dx.doi.org/10.1007/s00467-016-3430-5

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27271033


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    41 schema:description BackgroundAmong 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.MethodsChildren 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.ResultsForty-six children were followed (median follow-up, 9.23 years), and classified as children without (n = 38; Group A) or with (n = 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).ConclusionsInfants who initiate peritoneal dialysis complicated by prolonged respiratory disorders have increased adverse risk factors for mortality; therefore, withholding aggressive treatment should be considered.
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    49 ConclusionsInfants
    50 MethodsChildren
    51 PH severity
    52 adverse prognosis
    53 adverse risk factors
    54 aggressive treatment
    55 analysis
    56 birth
    57 children
    58 cohort
    59 comorbidities
    60 contact
    61 curves
    62 date
    63 days duration
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    65 decline
    66 definition
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    71 duration
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    74 evaluated risk factors
    75 factors
    76 final outcome
    77 group A.
    78 group B
    79 hypoplasia
    80 infancy
    81 infants
    82 kidney disease
    83 last contact
    84 long-term outcomes
    85 modalities
    86 mortality
    87 multivariate analysis
    88 outcomes
    89 peritoneal dialysis
    90 prognosis
    91 pulmonary disorders
    92 pulmonary hypoplasia
    93 rate
    94 respiratory disorders
    95 risk factors
    96 severity
    97 significant decline
    98 significant risk factors
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