TY - JOUR
T1 - Comparative clinical outcomes between pediatric and young adult dialysis patients
AU - Atkinson, Meredith A.
AU - Lestz, Rachel M.
AU - Fivush, Barbara A.
AU - Silverstein, Douglas M.
N1 - Funding Information:
The analyses upon which this publication is based were performed under Contract Number 500-2010-NW005C entitled End Stage Renal Disease Networks Organization for the District of Columbia, Maryland, Virginia and West Virginia, sponsored by the Centers for Medicare & Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare & Medicaid Services, which has encouraged the identification of quality improvement projects derived from the analysis of patterns of care and therefore required no special funding on the part of this contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcomed.
PY - 2011/12
Y1 - 2011/12
N2 - Published data on the comparative achievement of The Kidney Disease Dialysis Outcome Quality Initative (KDOQI) recommended clinical performance targets between children and young adults on dialysis are scarce. To characterize the achievement of KDOQI targets among children (<18 years) and young adults (18-24 years) with prevalent end stage renal disease (ESRD), we performed a cross-sectional analysis of data collected by the Mid-Atlantic Renal Coalition, in conjunction with the 2007 and 2008 ESRD Clinical Performance Measures Projects. Data on all enrolled pediatric dialysis patients, categorized into three age groups (0-8, 9-12, 13-17 years), and on a random sample of 5% of patients ≥18 years in ESRD Network 5 were examined for two study periods: hemodialysis (HD) data were collected from October to December 2006 and from October to December 2007 and peritoneal dialysis (PD) data were collected from October 2006 to March 2007 and from October 2007 to March 2008. In total, 114 unique patients were enrolled the study, of whom 41.2% (47/114) were on HD and 58.8% (67/114) on PD. Compared to the pediatric patients, young adults were less likely to achieve the KDOQI recommended serum phosphorus levels and serum calcium×phosphorus product values, with less than one-quarter demonstrating values at or below each goal. Multivariate analysis revealed that both young adults and 13- to 17-year-olds were less likely to achieve target values for phosphorus [young adults: odds ratio (OR) 0.04, 95% confidence interval (95% CI) 0.01-0.19, p<0.001; 13- to 17-year-olds: OR 0.17, 95% CI 0.04-0.77, p=0.02] and calcium×phosphorus product (young adults: OR 0.01, 95% CI 0.002-0.09, p <0.001; 13- to 17-year-olds: OR 0.09, 95% CI 0.02-0.56, p=0.01) than younger children. In summary, there are significant differences in clinical indices between pediatric and young adult ESRD patients.
AB - Published data on the comparative achievement of The Kidney Disease Dialysis Outcome Quality Initative (KDOQI) recommended clinical performance targets between children and young adults on dialysis are scarce. To characterize the achievement of KDOQI targets among children (<18 years) and young adults (18-24 years) with prevalent end stage renal disease (ESRD), we performed a cross-sectional analysis of data collected by the Mid-Atlantic Renal Coalition, in conjunction with the 2007 and 2008 ESRD Clinical Performance Measures Projects. Data on all enrolled pediatric dialysis patients, categorized into three age groups (0-8, 9-12, 13-17 years), and on a random sample of 5% of patients ≥18 years in ESRD Network 5 were examined for two study periods: hemodialysis (HD) data were collected from October to December 2006 and from October to December 2007 and peritoneal dialysis (PD) data were collected from October 2006 to March 2007 and from October 2007 to March 2008. In total, 114 unique patients were enrolled the study, of whom 41.2% (47/114) were on HD and 58.8% (67/114) on PD. Compared to the pediatric patients, young adults were less likely to achieve the KDOQI recommended serum phosphorus levels and serum calcium×phosphorus product values, with less than one-quarter demonstrating values at or below each goal. Multivariate analysis revealed that both young adults and 13- to 17-year-olds were less likely to achieve target values for phosphorus [young adults: odds ratio (OR) 0.04, 95% confidence interval (95% CI) 0.01-0.19, p<0.001; 13- to 17-year-olds: OR 0.17, 95% CI 0.04-0.77, p=0.02] and calcium×phosphorus product (young adults: OR 0.01, 95% CI 0.002-0.09, p <0.001; 13- to 17-year-olds: OR 0.09, 95% CI 0.02-0.56, p=0.01) than younger children. In summary, there are significant differences in clinical indices between pediatric and young adult ESRD patients.
KW - Dialysis
KW - KDOQI
KW - Targets
KW - Young adults
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U2 - 10.1007/s00467-011-1932-8
DO - 10.1007/s00467-011-1932-8
M3 - Article
C2 - 21643780
AN - SCOPUS:83055168488
SN - 0931-041X
VL - 26
SP - 2219
EP - 2226
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 12
ER -