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. 2023 Dec 28;17(1):sfad291.
doi: 10.1093/ckj/sfad291. eCollection 2024 Jan.

Comparative analysis of hospitalizations among patients treated with hemodialysis and peritoneal dialysis in European pediatric nephrology centers: results from a prospective EPDWG/ESPN Dialysis Working Group study

Sevcan A Bakkaloğlu  1 , Yeşim Özdemir Atikel  1   2 , Claus Peter Schmitt  3 , Eszter Lévai  3 , Shazia Adalat  4 , Nadine Goodman  5 , İsmail Dursun  6 , Ayşe Seda Pınarbaşı  6 , Burcu Yazıcıoğlu  1 , Fabio Paglialonga  7 , Karel Vondrak  8 , Isabella Guzzo  9 , Nikoleta Printza  10 , Aleksandra Zurowska  11 , Ilona Zagożdżon  11 , Aysun Karabay Bayazıt  12 , Bahriye Atmış  12 , Marcin Tkaczyk  13 , Maria do Sameiro Faria  14 , Ariane Zaloszyc  15 , Augustina Jankauskienė  16 , Mesiha Ekim  17 , Alberto Edefonti  7 , Rukshana Shroff  5
Affiliations

Comparative analysis of hospitalizations among patients treated with hemodialysis and peritoneal dialysis in European pediatric nephrology centers: results from a prospective EPDWG/ESPN Dialysis Working Group study

Sevcan A Bakkaloğlu et al. Clin Kidney J. .

Abstract

Background and hypothesis: Hospital admissions in pediatric dialysis patients need to be better studied, and most existing studies are retrospective and based on registry data. This study aimed to analyse and compare hospital admission rates, causes, length of stay (LOS), and outcomes in children treated with peritoneal dialysis (PD) and hemodialysis (HD).

Methods: Data from 236 maintenance PD and 138 HD patients across 16 European dialysis centers were collected between 1 July 2017 and 30 June 2018. A total of 178 hospitalized patients (103 PD, 75 HD) were included for further analyses.

Results: There were 465 hospitalization events (268 PD, 197 HD) with a rate of 0.39 admissions per 100 patient-days at risk (PDAR) and 2.4 hospital days per 100 PDAR. The admission rates were not significantly different between HD and PD patients. The most common causes of hospitalization were access-related infections (ARI) (17%), non-infectious complications of access (NIAC) (14%), and infections unrelated to access (12%). ARI was the leading cause in PD patients (24%), while NIAC was more common in HD patients (19%). PD patients had more ARIs, diagnostic procedures, and treatment adjustments (P < .05), while HD patients had more NIACs, infections unrelated to access, access placement procedures, and interventional/surgical procedures (P < .001). LOS was longer with acute admissions than non-acute admissions (P < .001). Overall LOS and LOS in the intensive care unit were similar between HD and PD patients. High serum uric acid and low albumin levels were significant predictors of longer LOS (P = .022 and P = .045, respectively). Young age, more significant height deficit, and older age at the start of dialysis were predictors of longer cumulative hospital days (P = .002, P = .001, and P = .031, respectively).

Conclusion: Access-related complications are the main drivers of hospitalization in pediatric dialysis patients, and growth and nutrition parameters are significant predictors of more extended hospital stays.

Keywords: children; hemodialysis; hospitalization; length of stay; peritoneal dialysis.

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Conflict of interest statement

S.A.B. is member of the CKJ Editorial Board. The other authors declare no competing conflicts of interest.

Figures

Graphical Abstract
Graphical Abstract
Figure 1:
Figure 1:
Flow diagram of the patients whose hospital admissions were evaluated. HD: hemodialysis; KTx: kidney transplantation PD: peritoneal dialysis.
Figure 2:
Figure 2:
The frequency distribution of hospital admissions overall and by dialysis modality. HD: hemodialysis; PD: peritoneal dialysis.
See this image and copyright information in PMC

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References

    1. Henning P, Tomlinson L, Rigden SPet al. . Long term outcome of treatment of end stage renal failure. Arch Dis Child 1988;63:35–40. 10.1136/adc.63.1.35 - DOI - PMC - PubMed
    1. Chand DH, Swartz S, Tuchman Set al. . Dialysis in children and adolescents: the pediatric nephrology perspective. Am J Kidney Dis 2017;69:278–86. 10.1053/j.ajkd.2016.09.023 - DOI - PubMed
    1. Molnar AO, Moist L, Klarenbach Set al. . Hospitalizations in dialysis patients in Canada: a national cohort study. Can J Kidney Health Dis 2018;5:2054358118780372. 10.1177/2054358118780372 - DOI - PMC - PubMed
    1. Bremer BA, McCauley CR, Wrona RMet al. . Quality of life in end-stage renal disease: a reexamination. Am J Kidney Dis 1989;13:200–9. 10.1016/S0272-6386(89)80053-8 - DOI - PubMed
    1. Saran R, Li Y, Robinson Bet al. . US Renal Data System 2015 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis 2016;67:Svii–305. 10.1053/j.ajkd.2015.12.014 - DOI - PMC - PubMed