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Renal replacement therapy in children: data from 12 registries in Europe

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Abstract

In June 2000 the ERA-EDTA Registry office moved to Amsterdam and started collecting core data on renal replacement therapy (RRT) entirely through national and regional registries. This paper reports the pediatric data from 12 registries. The analysis comprised 3,184 patients aged less than 20 years and starting RRT between 1980 and the end of 2000. The incidence of RRT rose from 7.1 per million of age-related population (pmarp) in the 1980–1984 cohort to 9.9 pmarp in the 1985–1989 cohort, and remained stable thereafter. The prevalence increased from 22.9 pmarp in 1980 to 62.1 in 2000. Hemodialysis was the commonest form of treatment at the start of dialysis, but peritoneal dialysis gained popularity during the late 1980s. Pre-emptive transplantation accounted for 18% of the first treatment modality in the 1995–2000 cohort. The relative risk of death of patients starting dialysis in the period 1995–2000 was reduced by 36% {adjusted hazard ratio (AHR) 0.64 [95% confidence interval (CI) 0.41–1.00]} and that of those receiving a first allograft by 42% [AHR 0.58 (95% CI 0.34–1.00)], compared with patients in the period 1980–1984. The prevalence of RRT in children has continued to rise, while its incidence has been stable for about 15 years. Patient survival has improved in both dialysis patients and transplant recipients. The development of this pediatric registry will form the basis for more-detailed and focused studies in the future.

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Acknowledgements.

We would like to thank the patients and staff of all the dialysis and transplant units who have contributed data via their national and regional renal registries. We also would like to thank the following registries for the contribution of these data: Austrian Dialysis and Transplant Registry (OEDTR), General Hospital of Wels, Wels, Austria (Dr. R. Kramar, Dr. H.K. Stumvoll); Dutch-speaking Belgian Registry (Dr. J. Donck, Ir H. Augustijn); French-Belgian Nephrologists Registry, Centre Hospitalier Etterbeek-Ixelles, Brussels, Belgium (Dr. F. Collart); Registry of Renal Patients (RMRC), Catalan Transplant Organization (OCATT), Barcelona, Spain (Dr. M. Clèries, Mr. E. Vela); Danish National Registry (Dr. H. Løkkegaard); Finnish Kidney Disease Registry and Department of Medicine, Helsinki University Hospital, Helsinki, Finland (Dr. C. Grönhagen-Riska, Dr. P. Finne); Greek National Registry, General Hospital of Athens G. Gennimatas, Athens, Greece (Dr. G.A. Ioannidis, Dr. N. Papagalanis); Icelandic Renal Registry, Landspitali—University Hospital, Reykjavik, Iceland (Dr. P. Asmundsson); Dutch End-Stage Renal Disease Registry (RENINE), Erasmus University Hospital, Rotterdam, The Netherlands (Dr. F.T. de Charro); Norwegian Renal Registry, Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway (Dr. T. Leivestad); Scottish Renal Registry, Glasgow Royal Infirmary, Glasgow, Scotland, UK (Dr. K. Simpson); Swedish Registry for Active treatment of Uremia, Skövde, Sweden (Dr. J. Ahlmén, Dr. S. Schön) and the other ERA-EDTA Registry committee members and ERA-EDTA Registry staff members for their advice in the analysis and the drafting of this paper: Dr. G. Colasanti, Ir. R. Cornet, Dr. F.W. Dekker, Dr. C. Grönhagen-Riska, Dr. T. Feest, Dr. H.J. Schober-Halstenberg, Dr. K. Simpson, Dr. B. Stengel, and Dr. D. Tsakiris. The ERA-EDTA Registry is funded by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). The following companies have committed funds in the form of unrestricted educational grants to assist the ERA-EDTA in the financial support of the Registry: Amgen, Baxter, Fresenius Medical Care, Gambro, Hoffmann-La Roche, Hospal, Ortho-Biotech and Shire.

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Authors and Affiliations

  1. Sophia Children’s Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands

    Bert J. van der Heijden

  2. ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Paul C. W. van Dijk, Kitty J. Jager & J. Douglas Briggs

  3. KRUF Children′s Kidney Center for Wales, University of Wales College of Medicine, Heath Park, Wales, Cardiff CF4 4XN, UK

    Kate Verrier-Jones

  4. ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, J.2–254, PO Box 22700, 1100 DE Amsterdam, The Netherlands

    Kitty J. Jager

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  1. Bert J. van der Heijden
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  2. Paul C. W. van Dijk
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  3. Kate Verrier-Jones
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  4. Kitty J. Jager
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  5. J. Douglas Briggs
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Corresponding author

Correspondence to Kitty J. Jager.

Appendix

Appendix

ERA-EDTA codes for primary renal disease (Table 5) and cause of death (Table 6) in children.

Table 5 ERA-EDTA codes for primary renal disease (PRD) in children (I glomerulonephritis/sclerosis, II pyelonephritis, III cystic kidneys, IV hypoplasia/dysplasia, V hemolytic uremic syndrome, VI hereditary nephropathy, VII miscellaneous, VIII unknown)
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Table 6 ERA-EDTA codes for cause of death (COD) in children (ESRF end-stage renal failure, I hyperkalemia, II cardiac arrest, III cardiac, other, IV cerebrovascular accident, V infection, VI malignancy, VII miscellaneous, VIII unknown/unavailable)
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van der Heijden, B.J., van Dijk, P.C.W., Verrier-Jones, K. et al. Renal replacement therapy in children: data from 12 registries in Europe. Pediatr Nephrol 19, 213–221 (2004). https://doi.org/10.1007/s00467-003-1376-x

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  • DOI: https://doi.org/10.1007/s00467-003-1376-x

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