Demographics and long‐term outcomes of children with end‐stage kidney disease: A 20‐year territory‐wide study

Aim To evaluate the demographics and long‐term patient outcomes of children with end‐stage kidney disease in Hong Kong. Methods We conducted a cohort study at the Paediatric Nephrology Centre, the designated site providing kidney replacement therapy (KRT) for children in Hong Kong. The clinical char...

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Published in:Nephrology (Carlton, Vic.) Vic.), 2022-02, Vol.27 (2), p.171-180
Main Authors: Chan, Eugene Yu Hin, Yap, Desmond Yat Hin, Wong, Wilfred Hing Sang, Ho, Tsz Wai, Tong, Pak Chiu, Lai, Wai Ming, Chan, Tak Mao, Ma, Alison Lap Tak
Format: Article
Language:English
Subjects:
Adolescent
Child
Children
Cohort Studies
Congenital defects
demographics
Demography
dialysis
end‐stage kidney disease
Female
Hemodialysis
Hong Kong
Humans
Kidney diseases
Kidney Failure, Chronic - therapy
Kidney transplantation
Kidney transplants
Male
Mortality
Multivariate analysis
Nephrology
Patients
Pediatrics
Peritoneal dialysis
Renal Replacement Therapy
Survival
Time Factors
transplant
Treatment Outcome
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Summary:Aim To evaluate the demographics and long‐term patient outcomes of children with end‐stage kidney disease in Hong Kong. Methods We conducted a cohort study at the Paediatric Nephrology Centre, the designated site providing kidney replacement therapy (KRT) for children in Hong Kong. The clinical characteristics and outcomes of all children who initiated chronic KRT before 19 years, between 2001 and 2020, were analysed. Results One hundred forty‐seven children (50% male) received KRT at a mean age of 11.4 ± 5.7 years. The incidence of ESKD was 6.28 per million age‐related population (pmarp). The leading cause of ESKD was congenital anomalies (33%). Ten children (7%) had pre‐emptive kidney transplants, 104 (71%) and 33 (22%) patients received automated peritoneal dialysis and haemodialysis as initial KRT. The incidence of ESKD increased over time, and were 4.38, 5.07, 6.15 and 9.17 pmarp during 2001–2005, 2006–2010, 2011–2015 and 2016–2020, respectively (p = .005). Ninty‐seven patients (66%) received kidney transplants and the median time to receive a kidney graft was 3.7 years (95% CI 3.1–4.3). Only 10 patients had pre‐emptive kidney transplants. The mortality rate was 9.1 deaths per 1000‐patient‐years (95%CI 4.6–16.2). The survival probabilities at 1‐, 5‐, 10‐ and 15‐year were 100%, 94.8% (95%CI 90.7–98.9%), 89.7% (95% CI 83.4%–95.9%), 87.1% (95% CI 79.3%–94.9%), respectively. Standardised mortality ratio was 54.5. 72% of deaths were due to infections. Young infants and those without kidney transplants were associated with worse survival (p 
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.14007