About My Health Careers Internship MedBlogs Contact us
Initiating Dialysis With Higher Kidney Function may Pose Death Risk in Children

Initiating Dialysis With Higher Kidney Function may Pose Death Risk in Children

Font : A-A+

  • In recent years, dialysis for children have been started at higher levels of kidney function
  • Children with higher kidney function at dialysis commencement are at a greater risk of death
  • The risk is even greater for the children with higher kidney function who are on hemodialysis compared to peritoneal dialysis
  • Delayed dialysis may prove beneficial for asymptomatic children

Higher kidney function at dialysis initiation was tied to lower survival in children, reports a new study. The study findings suggest that asymptomatic children with kidney failure may benefit from delaying dialysis.

Kidney Failure in Children

Kidney transplantation would be the ideal treatment for children suffering from kidney failure. However, most children began with dialysis prior to the transplant in order to address various issues like electrolyte balancing, removing excess fluids from the body, and alleviating excess fatigue.


Initiating Dialysis With Higher Kidney Function may Pose Death Risk in Children

A recent analysis of information on children with kidney failure in the US suggests that the risk of death was higher among the children who began their dialysis with higher kidney function levels. The data from two decades also indicated that children with kidney failure are being started on dialysis with higher kidney function. However, it has been unclear if the long-term health of the children is affected by the timing of dialysis initiation.

Details of the Study

Dr. Elaine Ku and Dr. Erica Winnicki of the University of California, San Francisco have led a team that analyzed the data on children from the United States who began dialysis between 1995 and 2015.

The team examined the patients' level of kidney function when the dialysis began. Kidney failure is defined by an estimated glomerular filtration rate (eGFR) below 15 ml/min/1.73m2, and for the research, an estimated glomerular filtration rate above 10 ml/min/1.73m2 defined higher kidney function and lower kidney function was 10 ml/min/1.73m2 or lower.

Findings of the Study

Among the 15,170 children whose data were analyzed, 4327 (29%) had higher kidney function when the dialysis was started. The risk of death was 1.36 times higher among this group of children. The risk was even greater for children who were on hemodialysis rather than peritoneal dialysis. The findings, which would be published in an upcoming issue of the Journal of the American Society of Nephrology, also suggest that delaying dialysis may benefit the asymptomatic children with  kidney failure.

"We also found that over a 20-year period, children are being started on dialysis with higher kidney function," said Dr. Winnicki. "Understanding why children are being started on dialysis at higher kidney function is important, as concerted efforts to delay dialysis initiation in asymptomatic children could potentially be an avenue for improvement in survival based on these observational findings. In addition, delaying dialysis initiation could allow for more time for living donors to undergo workup for kidney transplantation and shorten the time that children would need to spend on dialysis," she added.

In an accompanying editorial, it was noted that despite any evident benefit, children starting dialysis with an eGFR above 10 ml/min/1.73m2 have been increasing over the past 2 decades, which is concerning. The authors have quoted that, "The direct, immediate, and incontrovertible deleterious financial, psychosocial, and physical impacts of dialysis are experienced on a daily basis by clinicians, children, and their families."

Reference :
  1. Higher eGFR at Dialysis Initiation Is Not Associated with a Survival Benefit in Children - (https://jasn.asnjournals.org/content/early/2019/07/17/ASN.2018111130)

Source: Medindia

News A-Z
News Category
What's New on Medindia
January is the Thyroid Awareness Month in 2022
Menstrual Disorders
Coffee May Help You Fight Endometrial Cancer
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Acute Renal Failure Dialysis Height and Weight-Kids Urinary Stones In Children Vesico-Ureteric Reflux Causing UTI in Children Hydronephrosis / Antenatal Counseling Kidney Disease Death Facts Kidney Bereavement 

Recommended Reading
Novel Peritoneal Dialysis (PD) Fluid Benefits Chronic Kidney Failure Patients
Alanyl-glutamine, a cytoprotective agent in dialysis fluid helps patients by reducing the risks in ....
Increasing Fruit and Vegetable Consumption Lowers Early Death Risk in Dialysis Patients
Fruit and vegetable consumption among the hemodialysis population is low. However, a higher intake ....
Making Dialysis More Equitable and Sustainable
The focus of the dialysis reimbursement policies of many countries is skewed. This new study may ......
Foods to Avoid in Kidney Failure
Cut back on salt, restrict your fluid intake and limit consumption of proteins if you suffer from .....
Acute Renal Failure
Acute renal failure is the sudden cessation of the functioning of kidneys, that can be due to reduce...
Bereavement refers to grief, pain and sadness following the loss of a loved one, especially during t...
Dialysis is an artificial process for removing excess water and waste from the blood. Hemodialysis a...
Hydronephrosis / Antenatal Counseling
Currently most pregnant women undergo one or two ultrasound scans during their pregnancy....
Urinary Stones In Children
There is a wide misconception that only adults develop stones. On the contrary kidney stones are ver...
Vesico-Ureteric Reflux Causing UTI in Children
Bacterial infection of urinary bladder can cause pain and burning sensation while passing urine. Abn...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2022

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
open close
I have read and I do accept terms of use - Telemedicine

Advantage Medindia: FREE subscription for 'Personalised Health & Wellness website with consultation' (Value Rs.300/-)