ESPN 50th Annual Meeting

ESPN 2017


 
Mortality rate in children with ESRD due to neurogenic bladder in Polish Pediatric Renal Replacement Therapy Registry.
ILONA ZAGOżDżON 1 ALEKSANDRA ZUROWSKA 1 SYLWESTER PROKURAT 2 JACEK RUBIK 2 DOROTA DROZDZ 3 MARIA SZCZEPANSKA 4

1- DEPARTMENT PAEDIATRICS, NEPHROLOGY & HYPERTENSION, MEDICAL UNIVERSITY OF GDANSK
2- DEPARTMENT OF NEPHROLOGY & KIDNEY TRANSPLANTATION, THE CHILDRENS MEMORIAL HEALTH INSTITUTE,WARSAW
3- DIALYSIS UNIT JAGIELLONIAN UNIVERSITY MEDICAL COLLEGE,KRAKOW
4- DEPARTMENT AND CLINIC OF PEDIATRICS, NEPHROLOGY AND ENDOCRINOLOGY, MEDICAL UNIVERSITY OF SILESIA, ZABRZE
 
Introduction:

 There is scarce information in the medical literature on mortality in subjects with ESRD due to neurogenic bladder (NB) though it has been suggested that the long term survival of this group is inferior to that of children with other diagnoses. The aim of the study was to assess survival of children diagnosed with congenital neurogenic bladder in a cohort of patients treated with renal replacement therapy in Poland.  

Material and methods:

 A retrospective longitudinal analysis involving 1136 pediatric subjects  receiving renal replacement therapy in period 2000-2015 was conducted.  Cox proportional hazard method was used to analyse risk of death in children with neurogenic bladder compared to those  with other etiologies.

Results:

 58 children (42 girls, 16 boys) with neurogenic bladder were identified. Hemodialysis was  the dominant mode of initial therapy. 7 deaths were reported in this subgroup during 6659 patient-years of follow-up.  After adjusting for age, the risk of death among patients with neurogenic bladder was significantly higher than that of all other causes : hazard ratio  -2.95 (95% confidence interval  1.33-6.56). Subjects  with neurogenic bladder were older at start of RRT compared to other children (13.85 years vs. 10.13 years, p<0.001). Average age at death was higher than in the remaining  group 15,2 ± 6,9 year vs. 10,1 ±. 7,5 year. The main causes of death were cardiovascular events followed by infections.

Conclusions:

1.  Children with neurogenic bladder have three time higher mortality on RRT compared to children with other etiologies of ESRD.
2.    Age  for both  start of RRT and at death is higher  compared  to other children.
3.    The main causes of death (cardiovascular and infections) are similar to that observed in the  total cohort of children on RRT.