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Verfasst von:Thumfart, Julia Angelika [VerfasserIn]   i
 Wagner, Steffen [VerfasserIn]   i
 Kirchner, Marietta [VerfasserIn]   i
 Azukaitis, Karolis [VerfasserIn]   i
 Bayazit, Aysun K. [VerfasserIn]   i
 Obrycki, Lukasz [VerfasserIn]   i
 Canpolat, Nur [VerfasserIn]   i
 Bulut, Ipek Kaplan [VerfasserIn]   i
 Duzova, Ali [VerfasserIn]   i
 Anarat, Ali [VerfasserIn]   i
 Bessenay, Lucie [VerfasserIn]   i
 Shroff, Rukshana [VerfasserIn]   i
 Paripovic, Dusan [VerfasserIn]   i
 Sever, Lale [VerfasserIn]   i
 Candan, Cengiz [VerfasserIn]   i
 Lugani, Francesca [VerfasserIn]   i
 Yilmaz, Alev [VerfasserIn]   i
 Yalcinkaya, Fatos [VerfasserIn]   i
 Arbeiter, Klaus [VerfasserIn]   i
 Kiyak, Aysel [VerfasserIn]   i
 Zurowska, Aleksandra [VerfasserIn]   i
 Galiano, Matthias [VerfasserIn]   i
 Querfeld, Uwe [VerfasserIn]   i
 Melk, Anette [VerfasserIn]   i
 Schaefer, Franz [VerfasserIn]   i
Titel:Timing and modality of kidney replacement therapy in children and adolescents
Verf.angabe:Julia Thumfart, Steffen Wagner, Marietta Kirchner, Karolis Azukaitis, Aysun K. Bayazit, Lukasz Obrycki, Nur Canpolat, Ipek Kaplan Bulut, Ali Duzova, Ali Anarat, Lucie Bessenay, Rukshana Shroff, Dusan Paripovic, Lale Sever, Cengiz Candan, Francesca Lugani, Alev Yilmaz, Fatos Yalcinkaya, Klaus Arbeiter, Aysel Kiyak, Aleksandra Zurowska, Matthias Galiano, Uwe Querfeld, Anette Melk and Franz Schaefer; on behalf of the 4C Study Group
E-Jahr:2024
Jahr:September 2024
Umfang:9 S.
Illustrationen:Illustrationen
Fussnoten:Online verfügbar 12 June 2024, Version des Artikels 3 September 2024 ; Gesehen am 14.03.2025
Titel Quelle:Enthalten in: Kidney international. Reports
Ort Quelle:Amsterdam : Elsevier, 2016
Jahr Quelle:2024
Band/Heft Quelle:9(2024), 9 vom: Sept., Seite 2750-2758
ISSN Quelle:2468-0249
Abstract:Introduction - The choice and timing of kidney replacement therapy (KRT) is influenced by clinical factors, laboratory features, feasibility issues, family preferences, and clinicians' attitudes. We analyzed the factors associated with KRT modality and timing in a multicenter, multinational prospective pediatric cohort study. - Methods - A total of 695 pediatric patients with chronic kidney disease (CKD) enrolled into the Cardiovascular Comorbidity in Children with CKD (4C) study at age 6 to 17 years with estimated glomerular filtration rate (eGFR) of 10 to 60 ml/min per 1.73 m2 were investigated. Competing risk regression was performed to identify factors associated with initiation of dialysis or preemptive transplantation (Tx), including primary renal diagnosis, demographics, anthropometrics, and laboratory parameters. - Results - During the 8-year observation period, 342 patients (49%) started KRT. Of these, 200 patients started dialysis, whereas 142 patients underwent preemptive Tx. A lower eGFR at enrolment (Hazard ratio [HR]: 0.76 [95% confidence interval: 0.74-0.78]), a steeper eGFR slope (HR: 0.90 [0.85-0.95], and a higher systolic blood pressure SD score (SDS) (HR: 2.07 [1.49-2.87]) increased the likelihood of KRT initiation. Patients with glomerulopathies were more likely to start dialysis than children with congenital anomalies of the kidneys and urinary tracts (CAKUT) (HR: 3.81 [2.52-5.76]). Lower body mass index (BMI) SDS (HR: 0.73 [0.6-0.89]) and lower hemoglobin (HR: 0.8 [0.72-0.9]) were associated with higher likelihood of dialysis. A significant center effect was observed, accounting for 6.8% (dialysis) to 8.7% (preemptive Tx) of explained variation. - Conclusion - The timing and choice of KRT in pediatric patients is influenced by the rate of kidney function loss, the underlying kidney disease, nutritional status, blood pressure, anemia and center-specific factors.
DOI:doi:10.1016/j.ekir.2024.06.009
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

kostenfrei: Volltext: https://doi.org/10.1016/j.ekir.2024.06.009
 kostenfrei: Volltext: https://www.sciencedirect.com/science/article/pii/S2468024924017686
 DOI: https://doi.org/10.1016/j.ekir.2024.06.009
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:dialysis initiation
 pediatric risk factors
 progression kidney disease
K10plus-PPN:1919804889
Verknüpfungen:→ Zeitschrift

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