Recovery less likely in children with congenital anomalies
THURSDAY, Sept. 27, 2018 (HealthDay News) — Roughly 2 percent of pediatric patients on maintenance dialysis recover within two years after dialysis initiation, according to a study published online Sept. 20 in the Clinical Journal of the American Society of Nephrology.
Marjolein Bonthuis, Ph.D., from the University of Amsterdam, and colleagues studied the frequency of recovery of kidney function and its determinants in a large cohort of pediatric patients on maintenance dialysis in Europe. The European Society for Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry was used to identify 6,574 patients from 36 European countries beginning dialysis before the age of 15 years, between 1990 and 2014.
The researchers found that two years after dialysis initiation, 2 percent of patients experienced recovery of their kidney function after a median of 5.0 months on dialysis. Recovery occurred more often in patients with vasculitis (11 percent at two years; adjusted hazard ratio, 20.4), ischemic kidney failure (12 percent; adjusted hazard ratio, 11.4), and hemolytic uremic syndrome (13 percent; adjusted hazard ratio, 15.6), compared to patients with congenital anomalies of the kidney and urinary tract. Recovery was also associated with younger age and initiation on hemodialysis instead of peritoneal dialysis. For nearly one-third of patients who experienced recovery, the recovery was transient as they returned to kidney replacement therapy after a median recovery period of 19.7 months.
“There is a clinically important chance of recovery in patients on dialysis with vasculitis, ischemic kidney failure, and hemolytic uremic syndrome, which should be considered when planning kidney transplantation in these children,” the authors write.
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