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International Journal of Nephrology
Volume 2016, Article ID 2132387, 7 pages
http://dx.doi.org/10.1155/2016/2132387
Research Article

Impact of Pediatric Chronic Dialysis on Long-Term Patient Outcome: Single Center Study

1Institute of Nephrology, Schneider Children’s Medical Center of Israel, 49202 Petah Tikva, Israel
2Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel

Received 24 January 2016; Revised 14 May 2016; Accepted 21 June 2016

Academic Editor: David B. Kershaw

Copyright © 2016 Daniella Levy Erez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Owing to a shortage of kidney donors in Israel, children with end-stage renal disease (ESRD) may stay on maintenance dialysis for a considerable time, placing them at a significant risk. The aim of this study was to understand the causes of mortality. Study Design. Clinical data were collected retrospectively from the files of children on chronic dialysis (>3 months) during the years 1995–2013 at a single pediatric medical center. Results. 110 patients were enrolled in the study. Mean age was  yrs. (range: 1 month–24 yrs). Forty-five children (42) had dysplastic kidneys and 19 (17.5) had focal segmental glomerulosclerosis. Twenty-five (22.7) received peritoneal dialysis, 59 (53.6) hemodialysis, and 6 (23.6) both modalities sequentially. Median dialysis duration was 1.46 years (range: 0.25–17.54 years). Mean follow-up was  yrs. Seventy-nine patients (71.8) underwent successful transplantation, 10 (11.2) had graft failure, and 8 (7.3) continued dialysis without transplantation. Twelve patients (10.9) died: 8 of dialysis-associated complications and 4 of their primary illness. The 5-year survival rate was 84: 90 for patients older than 5 years and 61 for younger patients. Conclusions. Chronic dialysis is a suitable temporary option for children awaiting renal transplantation. Although overall long-term survival rate is high, very young children are at high risk for life-threatening dialysis-associated complications.