Longitudinal analysis of intermediate outcomes in adolescent hemodialysis patients.
In 2000 and 2001, The Centers for Medicare & Medicaid Services (CMS) End-Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project collected data on all in-center hemodialysis (HD) patients in the United States aged >or=12 and <18 years. There were 433 of 486 (89%) patients and 435 of 516 (84%) patients who had the minimum required data submitted and were included in the 2000 and 2001 study years, respectively. There were 188 patients (43%) who had data submitted in both study years, providing longitudinal data on this cohort. A comparison of clinical parameters on these 188 patients in the 2000 and 2001 study years reveals significant improvement in mean calculated spKt/V (1.50+/-0.36 vs. 1.58+/-0.30, P<0.01), mean hemoglobin (11.0+/-1.6 g/dl vs. 11.5+/-1.3 g/dl, P<0.001), mean ferritin (286+/-278 ng/ml vs. 460+/-353 ng/ml, P<0.001), mean transferrin saturation (27.8+/-15.1% vs. 31.3+/-15.0%, P<0.05), mean serum albumin as measured by the bromocresol green method (3.83+/-0.54 g/dl vs. 3.95+/-0.42 g/dl, P<0.01), and mean height standard deviation score (-1.814+/-1.756 vs. -1.699+/-1.657, P<0.05). In addition, 20 of 29 (69%) patients who had a spKt/V <1.2 in the 2000 study year had a spKt/V >1.2 in the 2001 study year. Of 68 (44%) patients who had a catheter as their HD access in the 2000 study year, 30 had an arteriovenous fistula or graft in the 2001 study year and 49 of 80 (61%) patients who had a mean hemoglobin <11 g/dl in the 2000 study year had a hemoglobin >11 g/dl in the 2001 study year. In summary, these longitudinal data demonstrate significant improvements in nearly all clinical parameters studied in these adolescent HD patients.
Neu
Alicia M
AM
Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2535, USA. aneu@jhmi.edu
Fivush
Barbara A
BA
Warady
Bradley A
BA
Watkins
Sandra L
SL
Friedman
Aaron L
AL
Brem
Andrew S
AS
Goldstein
Stuart
S
Frankenfield
Diane L
DL
D000293:Adolescent; D041923:Adolescent Development; D000740:Anemia / Q000188:drug therapy; D001166:Arteriovenous Shunt, Surgical; D001827:Body Height; D002408:Catheters, Indwelling; D015331:Cohort Studies; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin; D000068817:Epoetin Alfa