Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry
Bonthuis, Marjolein; Vidal, Enrico; Bjerre, Anna; Aydoğ, Özlem; Baiko, Sergey; Garneata, Liliana; Guzzo, Isabella; Heaf, James G; Jahnukainen, Timo; Lilien, Marc; Mallett, Tamara; Mirescu, Gabriel; Mochanova, Elena A; Nüsken, Eva; Rascher, Katherine; Roussinov, Dimitar; Szczepanska, Maria; Tsimaratos, Michel; Varvara, Askiti; Verrina, Enrico; Veselinović, Bojana; Jager, Kitty J; Harambat, Jérôme
(2021) Pediatric Nephrology, volume 36, issue 8, pp. 2337 - 2348
(Article)
Abstract
Background: For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods: We included all children aged <15 years starting KRT 2007–2016
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in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results: Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions: We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.
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Keywords: Dialysis, Epidemiology, ESPN/ERA-EDTA Registry, Hemodialysis, Pediatrics, Peritoneal dialysis, Transplantation, Nephrology, Pediatrics, Perinatology, and Child Health, Journal Article
ISSN: 0931-041X
Publisher: Springer Verlag
Note: Funding Information: We would like to thank the patients, their parents, and the staff of all the dialysis and transplant units who have contributed data via their national registries and contact persons. We also would like to thank R Topaloglu, J Oh, Z Massy, and MD Sinha for being members of the ESPN/ERA-EDTA Registry Committee; D Shtiza, R Kramar, D Pokrajac, K van Hoeck, and the Centre contributors to the Belgian Registry Committee; A Sukalo, I Sheuchuk, O Liachovskaya, A Dudarevic, D Kavalenka, E Maurer, GF Laube, CE Kuehni, H Chehade, and the Swiss Paediatric Renal Registry; A Elia, T Seeman, K Vondrak, K Krupka, B Höcker, L Pape, B Tönshoff, L Weber, G von Gersdorff, J Dötsch, F Schaefer, K Hommel, Ü Toots, A Alonso Melgar, and the Spanish Paediatric Registry; J Helve, P Finne, P-H Groop, C Couchoud, M Lassalle, E Berard, T Davitaia, G Moustakas, A Kapogiannis, A Mitsioni, N Printza, D Milosevic, M Ban, J Slavicek, D Arapovic, S Abdovic, G Reusz, Cs Berecki, A Szabó, T Szabó, A Barczi, O Lakatos, E Kis, A Awan, T Raftery, C Sweeney, N Dolan, M Riordan, M Stack, M Waldron, R Palsson, V Edvardsson, B Gianoglio, E La Porta, F Paglialonga, M Parolin, C Pecoraro, A Jankauskiene, S Rudiatis, A Popova, V Kuzema, H Čerņevskis, S Gatcan, O Berbeca, N Zaikova, N Revenco, E Sahpazova, N Abazi, S Pavićević, V Said-Conti, L Heuveling, and MH Hemmelder on behalf of the Nefrovisie foundation; JW Groothoff and all centers participating in the RichQ-study; A Åsberg, AV Reisæter, A Zurowska, I Zagozdzon, C Mota, R Stone, C Simão, M Kostić, B Spasojević, M Cvetković, I Gojković, D Paripović, G Miloševski-Lomić, NA Tomilina, KG Prütz, M Stendahl, M Evans, S Schön, M Segelmark, T Lundgren, L Podracka, G Kolvek, N Battelino, G Novljan, J Buturovic-Ponikvar, S Bakkaloglu, DD Ivanov, SP Fomina, L Plumb, F Braddon, A Casula, and H Maxwell for contributing data to the ESPN/ERA-EDTA Registry. Funding Information: The ESPN/ERA-EDTA Registry is funded by the European Society of Paediatric Nephrology (ESPN), and the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA). Furthermore, Amgen has agreed to provide an unrestricted grant to assist the ERA-EDTA on the financial support of the ESPN/ERA-EDTA Registry. This article was written by M Bonthuis et al. on behalf of the ESPN/ERA-EDTA Registry and the ERA-EDTA Registry which is an official body of the ERA-EDTA (European Renal Association–European Dialysis and Transplant Association). Publisher Copyright: © 2021, The Author(s).
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