Kidney Week

Abstract: PUB214

Analysis of Growth, Survival Rate, and Risk Factors in Low-Weight Children (<15 kg) Undergoing Chronic Hemodialysis

Session Information

• Publication Only

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Henriques, Cristina Lucia, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Cristina Lucia Henriques, MD

• Vieira, Simone, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Simone Vieira, MS, MSc

• Carvalho, Maria Fernanda Camargo, Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Maria Fernanda Camargo Carvalho, MD

• Koch Nogueira, Paulo C., Hospital Samaritano de Sao Paulo, São Paulo, SP, Brazil

Paulo C. Koch Nogueira, MD

Background

Treatment of low weight children (less than 15 kg) with chronic kidney disease is a major challenge and requires monitoring by a multidisciplinary team. Our objectives are to evaluate growth and survival rate (at 3 years) and its risk factors in low weight children undergoing chronic hemodialysis (HD).

Methods

Retrospective analysis from January 2015 to 2026.
Growth analysis: multilevel mixed-effects linear regression, with height/age Z-score as the objective and interaction between time and anuria as risk factors.
3-years survival rate: concurrent risk regression, with kidney transplantation as a competing event.

Results

108 patients (81 male)
Median age at the start of dialysis was 3.2 months and at the start of the study 11 months. Median weight (start of study) 7.5 kg (Z-score: -3.2) and height 71 cm (Z-score: -3.8). Etiology 53% CAKUT. 51% anuric, 10% with congenital heart disease, 88% underwent daily hemodialysis, 70% underwent peritoneal dialysis previously. Median time on HD: 1.8 years.
Patients with residual renal function showed superior growth (with an increase in height/age Z-score during HD), unlike anuric patients (worsening of height/age Z-score).
The survival rate was: 1 year: 90%, 2 years: 77% and 3 years: 68%. Anuria and the presence of congenital heart disease were the factors with the greatest impact on the survival rate. Younger age at the start of dialysis also has a negative impact on the survival rate.

Conclusion

HD is a feasible treatment in young children with Chronic Kidney Disease who require renal replacement therapy while awaiting kidney transplantation. The presence of congenital heart disease has a negative impact on survival rate. Anuria has a negative impact on growth and survival rate, making the preservation of residual renal function in these patients of great importance.

Acknowledgment

Thanks to the multidisciplinary team of Pediatric Hemodialysis.