Incidence of initial renal replacement therapy over the course of kidney disease in children.

Incidence of initial renal replacement therapy over the course of kidney disease in children. Am J Epidemiol. 2019 Oct 09;: Authors: Ng DK, Matheson MB, Warady BA, Mendley SR, Furth SL, Muñoz A Abstract The prospective Chronic Kidney Disease in Children cohort with data collected from 2003 to 2018 provided the first opportunity to characterize the incidence of renal replacement therapy (RRT) initiation over the life course of pediatric kidney diseases. Parametric generalized gamma models were fit and extrapolated for overall RRT, and by specific modality (dialysis or preemptive transplant). Children were stratified by diagnosis: n=650 with non-glomerular (mostly congenital), n=49 glomerular-hemolytic uremic syndrome, and n=216 with glomerular-non-HUS (heterogeneous childhood onset). Estimated years to RRT after disease onset for 99% of the non-glomerular and glomerular-non-HUS groups were 42.5 (95%CI: 31.0, 54.1) and 25.4 (95%CI: 14.9, 36.0), respectively. Since onset for the great majority of the non-glomerular group was congenital, disease duration equates to age. A simulation-based estimate of age at RRT for 99% of the glomerular population was 37.9 years (95%CI: 33.6, 63.2). These models performed well in cross-validation. Children with glomerular disease received dialysis earlier and were less likely to have preemptive transplant, while modality incidence was similar for the non-glomerular group. These diagnosis-specific estima...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research