Author/Authors :
Yousefifard, Mahmoud Shahid Beheshti University of Medical Sciences, Tehran , Ataei, Neamatollah Department of Pediatric Nephrology - Children’s Hospital Medical Center - Tehran University of Medical Sciences, Tehran , Roshani, Shahin Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Darabi, Fatemeh Department of Public Health - Asadabad School of Medical Sciences, Asadabad , Najafi, Iraj Shariati Hospital - Tehran University of Medical Sciences, Tehran , Fazel, Mojtaba Department of Pediatric Nephrology - Children’s Hospital Medical Center - Tehran University of Medical Sciences, Tehran , Talayi, Zeynab Pediatric Department - Valiasr Hospital - Tehran University of Medical Sciences, Tehran , Jones, Michael E Division of Genetics and Epidemiology - The Institute of Cancer Research - London, UK , Yaseri, Mehdi Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Hosseini, Mostafa Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran
Abstract :
Background: There is little information about the survival rate of pediatric peritoneal dialysis (PD) patients and its risk factors. Therefore, the aim of the present study was to assess survival rate and its risk factors in Iranian children undergoing PD. Materials and Methods: Demographic and laboratory data of 407 Iranian children (up to 19 years old) undergoing PD, from 20 centers in Iran were included. The outcome of interest in our study was survival rate and determination of its risk factors in PD children. The joint models of longitudinal and time-to-event data analysis was used. Results: The median duration of follow-up was 537 (interquartile range: 146 to 1,177) days. Finally, 72 (17.7%) patients died during a period of 23 years. Our results showed that one-year survival rate of PD patients was 93.6% and five-year survival rate was 76.9%. In addition, the most important risk factors for the PD all-cause mortality were age (HR=0.9301; 95% CI: 0.9031 to 0.9587), serum creatinine (HR=0.8907; 95% CI: 0.8138 to 0.9750), platelet count (HR=0.9999; 95% CI: 0.99995 to 0.99999), aspartate aminotransferase level (HR=1.0001; 95% CI: 0.9999, 1.0002), alkaline phosphatase (HR=0.9989; 95% CI: 0.9982 to 0.9997), renal solute clearance rate (HR=0.9839; 95% CI: 0.9700 to 0.9981), and normalized protein catabolic rate (HR=0.4031; 95% CI: 0.1879, 0.8648). Conclusion: The survival rate of Iranian pediatric PD patients is similar to other countries. It is suggested that laboratory assessment be continually evaluated in PD patients to reduce the risk of death.
Keywords :
Children , Mortality , Peritoneal Dialysis , Survival , Risk Factors
