Luebbe, Katrin, Nuesken, Eva, Rascher, Katherine, von Gersdorff, Gero, Cramer, Heyke, Samel, Christina, Barth, Claudia, Bach, Dieter, Weber, Lutz T. and Doetsch, Joerg (2019). Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry. Pediatr. Nephrol., 34 (7). S. 1229 - 1237. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Background Paediatric dialysis patients still suffer from high morbidity rates. To improve this, quality assurance programs like the German QiNKid (Quality in Nephrology for Children)-Registry have been developed. In our study, the significance of underlying renal disease on a range of clinical and laboratory parameters impacting morbidity and mortality was analysed. Our aim was to evaluate whether or not disease-specific dialysis strategies should be considered in planning dialysis for a patient. Methods Inclusion criteria were defined as follows: (1) CAKUT (congenital anomalies of the kidney and urinary tract) or glomerular disease patient, (2) < 18 years of age, (3) haemodialysis or peritoneal dialysis patient. Only measurements obtained from day 90 to 365 after the date of the first dialysis in the registry were analysed. Laboratory (serum albumin, haemoglobin, ferritin, calcium, phosphate, parathyroid hormone) and clinical parameters (height, blood pressure) were analysed using mixed effects models accounting for the correlation of repeated measures in individual patients. Results The study cohort comprised n = 167 CAKUT and n = 55 glomerular disease patients. Glomerular disease patients had significantly higher odds of hypoalbuminemia (OR 13.90, 95% CI 1.35-159.99; p = 0.0274), anaemia (OR 3.31, 95% CI 1.22-9.13; p = 0.0197), hyperphosphatemia (OR 9.69, 95% CI 2.65-37.26; p = 0.0006) and diastolic hypertension (OR 3.38, 95% CI 1.20-9.79; p = 0.0212). Conclusions Glomerular disease patients might require more intensive dialysis regimens. The evaluation of hydration status should be given more attention, since conditions differing between the cohorts can be linked to overhydration. The QiNKid-Registry allows monitoring of the quality of paediatric dialysis in a nationwide cohort.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Luebbe, KatrinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nuesken, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rascher, KatherineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Gersdorff, GeroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cramer, HeykeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samel, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barth, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bach, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, Lutz T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doetsch, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-137220
DOI: 10.1007/s00467-019-04218-6
Journal or Publication Title: Pediatr. Nephrol.
Volume: 34
Number: 7
Page Range: S. 1229 - 1237
Date: 2019
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-198X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RENAL REPLACEMENT THERAPY; CHRONIC KIDNEY-DISEASE; MINERAL METABOLISM; DIALYZED CHILDREN; VASCULAR DAMAGE; BLOOD-PRESSURE; RISK-FACTORS; MORTALITY; ANEMIA; ALBUMINMultiple languages
Pediatrics; Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13722

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