1
|
Akarkach A, Burgmaier K, Sander A, Hooman N, Sever L, Cano F, Zambrano P, Bilge I, Flynn JT, Yavascan O, Vallés PG, Munarriz RL, Patel HP, Serdaroglu E, Koch VH, Suarez ADC, Galanti M, Celedon CG, Rébori A, Kari JA, Wong CJ, Elenberg E, Rojas LF, Warady BA, Liebau MC, Schaefer F. Maintenance Peritoneal Dialysis in Children With Autosomal Recessive Polycystic Kidney Disease: A Comparative Cohort Study of the International Pediatric Peritoneal Dialysis Network Registry. Am J Kidney Dis 2020; 75:460-464. [PMID: 31983502 DOI: 10.1053/j.ajkd.2019.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 10/06/2019] [Indexed: 01/18/2023]
Affiliation(s)
- Abdelaziz Akarkach
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany
| | - Kathrin Burgmaier
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany
| | - Anja Sander
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Nakysa Hooman
- Ali-Asghar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
| | - Lale Sever
- Pediatric Nephrology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Francisco Cano
- Division of Pediatrics, Luis Calvo Mackenna Children's Hospital, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Ilmay Bilge
- Department of Pediatric Nephrology, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Joseph T Flynn
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; Division of Nephrology, Seattle Children's Hospital, Seattle, WA
| | - Onder Yavascan
- Department of Pediatric Nephrology, Tepecik Teaching and Research Hospital, Izmir, Turkey
| | | | | | - Hiren P Patel
- Department of Pediatrics, Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH
| | - Erkin Serdaroglu
- Department of Pediatric Nephrology, Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Vera H Koch
- Pediatric Nephrology Unit, Instituto da Criança Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Angela Del Carmen Suarez
- Department of Nephrology, Hospital de Niños Sor María Ludovica La Plata, Buenos Aires, Argentina
| | - Monica Galanti
- Pediatric Nephrology, Roberto del Río Hospital, Santiago, Chile
| | | | - Anabella Rébori
- Pediatric Dialysis Unit, Senniad, Hospital Evangelico, Montevideo, Uruguay
| | - Jameela A Kari
- Pediatric Nephrology Center of Excellence and Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Cynthia J Wong
- Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | | | - Luisa F Rojas
- Baxter Servicio al Cliente Colombia, Medellin-Antioquia, Colombia
| | - Bradley A Warady
- Division of Nephrology, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Max C Liebau
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany; Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University Hospital of Heidelberg, Heidelberg, Germany.
| | | |
Collapse
|
2
|
Mallett TM, O'Hagan E, McKeever KG. Early bilateral nephrectomy in infantile autosomal recessive polycystic kidney disease. BMJ Case Rep 2015; 2015:bcr-2015-211106. [PMID: 26670891 DOI: 10.1136/bcr-2015-211106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The management of neonatal autosomal recessive polycystic kidney disease (ARPKD) complicated by severe pulmonary insufficiency presents complex clinical challenges. Where massive nephromegaly exists, early bilateral nephrectomy, supportive peritoneal dialysis and early aggressive nutrition can minimise infant mortality. Consensus, however, is lacking on the role and optimal timing of nephrectomy, with decision-making driven by the patient's clinical condition and the expertise of the centre. We report on our experience of an infant with ARPKD requiring neonatal renal replacement therapy and survival at 14 months following early bilateral nephrectomy.
Collapse
Affiliation(s)
- Tamara Mary Mallett
- Department of Paediatric Nephrology, Royal Belfast Hospital for Sick Children, Belfast, UK Department of Paediatric Nephrology, Royal Bristol Hospital for Children, Bristol, UK
| | - Emma O'Hagan
- Department of Paediatric Nephrology, Royal Belfast Hospital for Sick Children, Belfast, UK Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester, UK
| | - Karl Gerard McKeever
- Department of Paediatric Nephrology, Royal Belfast Hospital for Sick Children, Belfast, UK
| |
Collapse
|
3
|
Carey WA, Martz KL, Warady BA. Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life. Pediatrics 2015; 136:e615-22. [PMID: 26304827 DOI: 10.1542/peds.2015-0980] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Among children with end-stage renal disease (ESRD), those who abstract initiated chronic dialysis during the first year of life historically were less likely to survive or receive a kidney transplant compared with those who initiated dialysis later in childhood.We hypothesized that recently treated infants have experienced improved outcomes. METHODS We queried the North American Pediatric Renal Trials and Collaborative Studies database, obtaining information on 628 children who initiated maintenance peritoneal dialysis for treatment of ESRD at ,1 year of age. We further subcategorized these children by age(neonates, #31 days and infants, 32–365 days) and date of dialysis initiation (past,1992–1999, and recent, 2000–2012). RESULTS Survival while on dialysis and overall survival were significantly better among neonates and infants in the recent cohort. Overall survival at 3 years after dialysis initiation was 78.6%and 84.6% among the recently treated neonates and infants, respectively. Neonates and infants in the recent cohort also were more likely to terminate dialysis for transplantation, and graft survival was improved among recently transplanted infants (3-year graft survival 92.1%). CONCLUSIONS Among children who initiate chronic peritoneal dialysis for treatment of ESRD in the first year of life, survival has improved in recent years. Graft survival also has improved for the subset of these patients who received a kidney transplant.
Collapse
Affiliation(s)
- William A. Carey
- Division of Neonatal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Bradley A. Warady
- Division of Pediatric Nephrology, Children’s Mercy Hospital, Kansas City, Missouri
| |
Collapse
|
4
|
Hartung EA, Guay-Woodford LM. Autosomal recessive polycystic kidney disease: a hepatorenal fibrocystic disorder with pleiotropic effects. Pediatrics 2014; 134:e833-45. [PMID: 25113295 PMCID: PMC4143997 DOI: 10.1542/peds.2013-3646] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2014] [Indexed: 12/31/2022] Open
Abstract
Autosomal recessive polycystic kidney disease (ARPKD) is an important cause of chronic kidney disease in children. The care of ARPKD patients has traditionally been the realm of pediatric nephrologists; however, the disease has multisystem effects, and a comprehensive care strategy often requires a multidisciplinary team. Most notably, ARPKD patients have congenital hepatic fibrosis, which can lead to portal hypertension, requiring close follow-up by pediatric gastroenterologists. In severely affected infants, the diagnosis is often first suspected by obstetricians detecting enlarged, echogenic kidneys and oligohydramnios on prenatal ultrasounds. Neonatologists are central to the care of these infants, who may have respiratory compromise due to pulmonary hypoplasia and massively enlarged kidneys. Surgical considerations can include the possibility of nephrectomy to relieve mass effect, placement of dialysis access, and kidney and/or liver transplantation. Families of patients with ARPKD also face decisions regarding genetic testing of affected children, testing of asymptomatic siblings, or consideration of preimplantation genetic diagnosis for future pregnancies. They may therefore interface with genetic counselors, geneticists, and reproductive endocrinologists. Children with ARPKD may also be at risk for neurocognitive dysfunction and may require neuropsychological referral. The care of patients and families affected by ARPKD is therefore a multidisciplinary effort, and the general pediatrician can play a central role in this complex web of care. In this review, we outline the spectrum of clinical manifestations of ARPKD and review genetics of the disease, clinical and genetic diagnosis, perinatal management, management of organ-specific complications, and future directions for disease monitoring and potential therapies.
Collapse
Affiliation(s)
- Erum A Hartung
- Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Lisa M Guay-Woodford
- Center for Translational Science, Children's National Health System, Washington, District of Columbia
| |
Collapse
|