Twichell Sarah A, Fiascone John, Gupta Munish, Prendergast Michael, Rodig Nancy, Hansen Anne
Division of Nephrology, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
Neonatology. 2017;112(1):73-79. doi: 10.1159/000456647. Epub 2017 Mar 31.
Information regarding morbidity and mortality of infants born with end-stage renal disease (ESRD) requiring dialysis early in life is critical to optimize patient care and better counsel families.
We evaluated outcomes of infants born regionally with ESRD, and those within our broader catchment area referred for dialysis.
We screened deaths at 5 regional referral hospitals, identifying infants with ESRD who did not survive to transfer for dialysis. We also screened all infants <8 weeks old seen at our institution over a 7-year period with ESRD referred for dialysis. We evaluated factors associated with survival to dialysis and transplant.
We identified 14 infants from regional hospitals who died prior to transfer and 12 infants at our institution who were dialyzed. Because of the large burden of lethal comorbidities in our regional referral centers, overall survival was low, with 73% dying at birth hospitals. Amongst dialyzed infants, 42% survived to transplant.
This study is unusual in reporting survival of infants with ESRD including those not referred for dialysis, which yields an expectedly lower survival rate than reported by dialysis registries.
有关患有终末期肾病（ESRD）且在生命早期需要透析的婴儿的发病率和死亡率的信息对于优化患者护理以及更好地为家庭提供咨询至关重要。
我们评估了本地区出生的患有ESRD的婴儿以及我们更大服务范围内被转诊进行透析的婴儿的结局。
我们在5家地区转诊医院筛查死亡病例，确定未存活至转诊进行透析的患有ESRD的婴儿。我们还筛查了在7年期间在我们机构就诊的所有8周龄以下被转诊进行透析的患有ESRD的婴儿。我们评估了与存活至透析和移植相关的因素。
我们从地区医院确定了14名在转诊前死亡的婴儿以及我们机构中12名接受透析的婴儿。由于我们地区转诊中心存在大量致命合并症，总体存活率较低，73%的婴儿在出生医院死亡。在接受透析的婴儿中，42%存活至移植。
本研究在报告患有ESRD的婴儿的存活率方面具有独特性，包括那些未被转诊进行透析的婴儿，其存活率预计低于透析登记处报告的存活率。
