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Kidney Week

Abstract: TH-PO781

Mortality in Children with ESRD: A Guatemalan Retrospective Cohort Study

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Morales, Josue Abraham, Universidad de San Carlos, Guatemala, Guatemala
  • Aguilar, Angie Lizet, Fundanier, Guatemala, Guatemala
  • Lou-Meda, Randall M., Fundanier, Guatemala, Guatemala
  • Almorza, Larissa María, Universidad de San Carlos, Guatemala, Guatemala
Background

Mortality rates and long-term survival data in ESRD children are sparse although different modalities of RRT have been used during decades
We evaluate the mortality overtime in a tertiary hospital in Guatemala

Methods

After ethics approval, we performed a single center retrospective cohort study of all patients with ESRD younger than 18 years, between Jan2015 and Dec2017
Mortality rate was expressed as number of deaths/1000patients
Mortality incidence rate, expressed as number of deaths/100patient-years was determined by, sex, RRT and age
Long-term survival rates were calculated by Kaplan Meier test and significant confirm by Log Rank and Breslow tests

Results

A total of 370 charts were reviewed. Of those, 115 were from PD, 221 from HD and 34 from transplant. During the study period 25 patients died. Of those, 52%(13/25) were female, the mean age was 12.7yr(SD 3.4), 72%(18/25) were from HD and the rest from PD(7/25). No deaths from transplanted patients were reported during the study. The mortality rate in 2015, 2016 and 2017 were 50, 50 and 32/1000patients. The mortality incidence rate was 8.20/100patient-years. No difference in mortality incidence rate was found by sex (fem 8/100patient-years, masc 8.4/100patient-years). The highest incidence of mortality rate was found in the HD and in the 5-9 age group (17.35/100patient-years, 20/100patient-years). When analyzing long-term survival rates using Kaplan Meier, the overall mortality rate at 3 years was 20%; no significant difference was identified by sex (p, 0.509) nevertheless; a significant difference was found between HD(38%) and PD(16%), p, 0.001. Regarding age, no significant difference in mortality rate between the 5-9, 10-14 and 15-18 age groups was identified at 2 years (25%,15%,10%), (p, 0.174)

Conclusion

In our study, the overall mortality incidence rate was higher than reported in literature
Mortality rate, incidence mortality rate and long-term survival were similar between the sexes. Among age, the 5-9 years group demonstrated the highest mortality rates
Regarding RRT, the incidence mortality rates in PD is comparable with literature; however, our HD mortality rates are 4 times higher than what has patient-years
Increasing the proportion of children treated with renal transplantation and PD rather than HD can improve survival further and costs in our centre