Higher eGFR at Dialysis Initiation Is Not Associated with a Survival Benefit in Children.
DOI: 10.1681/ASN.2018111130; PMCID: PMC6683704 (available on 2020-08-01)
BACKGROUND: Study findings suggest that initiating dialysis at a higher eGFR level in adults with ESRD does not improve survival. It is less clear whether starting dialysis at a higher eGFR is associated with a survival benefit in children with CKD.
METHODS: To investigate this issue, we performed a retrospective cohort study of pediatric patients aged 1-18 years who, according to the US Renal Data System, started dialysis between 1995 and 2015. The primary predictor was eGFR at the time of dialysis initiation, categorized as higher (eGFR>10 ml/min per 1.73 m
RESULTS: Of 15,170 children, 4327 (29%) had a higher eGFR (median eGFR, 12.8 ml/min per 1.73 m
CONCLUSIONS: In children with ESRD, a higher eGFR at dialysis initiation is associated with lower survival, particularly among children whose initial treatment modality is hemodialysis.
Journal of the American Society of Nephrology : JASN
Adolescent; Child; Child, Preschool; Creatinine; Female; Glomerular Filtration Rate; Humans; Infant; Kaplan-Meier Estimate; Kidney Failure, Chronic; Male; Peritoneal Dialysis; Renal Dialysis; Retrospective Studies; Treatment Outcome; United States
ESRD; dialysis; pediatric nephrology
Winnicki, E., Johansen, K. L., Cabana, M. D., Warady, B. A., McCulloch, C. E., Grimes, B., Ku, E. Higher eGFR at Dialysis Initiation Is Not Associated with a Survival Benefit in Children. Journal of the American Society of Nephrology : JASN 30, 1505-1513 (2019).