title: Twenty-five years of infant dialysis: a single center experience.
abstract: OBJECTIVE
  To perform a retrospective analysis of the long-term outcome of infants with end-stage kidney disease (ESKD) treated at our center during the past 25 years.
  
  
  METHODS
  The total cohort (n = 52) was divided into era 1 (1983-1995; n = 23) and era 2 (1996-2008; n = 29). Dialysis morbidity, transplantation, and long-term survival rates were assessed and compared between the 2 eras.
  
  
  RESULTS
  Average age at initiation of dialysis was 4.4 +/- 5.3 months (range, 0.5-18 months), with 96% begun on peritoneal dialysis. The predominant diagnoses were dysplasia/obstructive uropathy and autosomal recessive polycystic kidney disease. The overall survival rate is 46%, with current age of survivors ranging from 1.5 to 25 years. Mortality rates in the 2 eras were not significantly different. The predominant mortality occurred within the first year. Twenty-four patients received an initial renal transplant at 2.6 +/- 1.7 years of age. Six patients (25%) required a second renal allograft. Increased risk for mortality included African-American ethnicity, oligoanuria, autosomal recessive polycystic kidney disease, and co-morbid diagnoses.
  
  
  CONCLUSIONS
  Long-term survival is possible in infants with ESKD, although mortality and morbidity remain high. Technical innovations are needed to accommodate smaller infants undergoing dialysis. Early initiation of dialysis treatment is preferable because prognostic indicators remain poorly defined.
authors.affiliation: Division of Pediatric Nephrology, University of Miami/Holtz Children's Hospital, Miami, FL, USA.
authors.forename: Rana
authors.initials: R
authors.lastname: Hijazi
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Abitbol
authors.forename: Jayanthi
authors.initials: J
authors.lastname: Chandar
authors.forename: Wacharee
authors.initials: W
authors.lastname: Seeherunvong
authors.forename: Michael
authors.initials: M
authors.lastname: Freundlich
authors.forename: Gastón
authors.initials: G
authors.lastname: Zilleruelo