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Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes

Background and Objectives: Pediatric renal replacement therapy (RRT) in Lithuania resumed in 1994 after a 12-year pause in renal transplantation. Management of end stage renal disease (ESRD) has changed, and outcomes have improved over decades. Our aim was to evaluate the dynamics of RRT in Lithuani...

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Autores principales: Viršilas, Ernestas, Čerkauskienė, Rimantė, Masalskienė, Jūratė, Rudaitis, Šarūnas, Dobilienė, Diana, Jankauskienė, Augustina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262335/
https://www.ncbi.nlm.nih.gov/pubmed/30400223
http://dx.doi.org/10.3390/medicina54050078
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author Viršilas, Ernestas
Čerkauskienė, Rimantė
Masalskienė, Jūratė
Rudaitis, Šarūnas
Dobilienė, Diana
Jankauskienė, Augustina
author_facet Viršilas, Ernestas
Čerkauskienė, Rimantė
Masalskienė, Jūratė
Rudaitis, Šarūnas
Dobilienė, Diana
Jankauskienė, Augustina
author_sort Viršilas, Ernestas
collection PubMed
description Background and Objectives: Pediatric renal replacement therapy (RRT) in Lithuania resumed in 1994 after a 12-year pause in renal transplantation. Management of end stage renal disease (ESRD) has changed, and outcomes have improved over decades. Our aim was to evaluate the dynamics of RRT in Lithuania in the period 1994–2015, describe its distinctive features, and compare our results with other countries. Materials and Methods: Data between 1994 and 2015 were collected from patients under the age of 18 years with ESRD receiving RRT. The data included: Hemodialysis (HD), peritoneal dialysis (PD), transplantation incidence and prevalence, transplant waiting time, dialysis modalities before transplantation, causes of ESRD and gender distribution in transplanted patients, and patient and graft survival. Results: RRT incidence and prevalence maintained an increase up until 2009. Sixty-four transplantations were performed. Juvenile nephronophthisis (25.9%) was the primary cause of ESRD in transplanted children. The transplant waiting time median was 8.0 months. The male to female ratio post-transplantation was 1.02. Patient survival after transplantation at 10 years was 90.0%, while graft survival for living (related) was 77.0% and 51.1% for deceased. Twelve patients died while on RRT. Conclusions: RRT numbers are increasing in Lithuania. HD is the primary treatment of choice before transplantation, with continued low numbers of preemptive transplantation. Patient survival post-transplantation is favorable, though graft survival is less satisfactory.
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spelling pubmed-62623352018-12-05 Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes Viršilas, Ernestas Čerkauskienė, Rimantė Masalskienė, Jūratė Rudaitis, Šarūnas Dobilienė, Diana Jankauskienė, Augustina Medicina (Kaunas) Article Background and Objectives: Pediatric renal replacement therapy (RRT) in Lithuania resumed in 1994 after a 12-year pause in renal transplantation. Management of end stage renal disease (ESRD) has changed, and outcomes have improved over decades. Our aim was to evaluate the dynamics of RRT in Lithuania in the period 1994–2015, describe its distinctive features, and compare our results with other countries. Materials and Methods: Data between 1994 and 2015 were collected from patients under the age of 18 years with ESRD receiving RRT. The data included: Hemodialysis (HD), peritoneal dialysis (PD), transplantation incidence and prevalence, transplant waiting time, dialysis modalities before transplantation, causes of ESRD and gender distribution in transplanted patients, and patient and graft survival. Results: RRT incidence and prevalence maintained an increase up until 2009. Sixty-four transplantations were performed. Juvenile nephronophthisis (25.9%) was the primary cause of ESRD in transplanted children. The transplant waiting time median was 8.0 months. The male to female ratio post-transplantation was 1.02. Patient survival after transplantation at 10 years was 90.0%, while graft survival for living (related) was 77.0% and 51.1% for deceased. Twelve patients died while on RRT. Conclusions: RRT numbers are increasing in Lithuania. HD is the primary treatment of choice before transplantation, with continued low numbers of preemptive transplantation. Patient survival post-transplantation is favorable, though graft survival is less satisfactory. MDPI 2018-11-02 /pmc/articles/PMC6262335/ /pubmed/30400223 http://dx.doi.org/10.3390/medicina54050078 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Viršilas, Ernestas
Čerkauskienė, Rimantė
Masalskienė, Jūratė
Rudaitis, Šarūnas
Dobilienė, Diana
Jankauskienė, Augustina
Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title_full Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title_fullStr Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title_full_unstemmed Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title_short Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes
title_sort renal replacement therapy in children in lithuania: challenges, trends, and outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262335/
https://www.ncbi.nlm.nih.gov/pubmed/30400223
http://dx.doi.org/10.3390/medicina54050078
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