title: No difference in meeting hemoglobin and albumin targets for dialyzed children with urologic disorders.
abstract: Urologic disorders are the most common cause of chronic kidney disease in children. To determine whether children with urologic etiology of end-stage renal disease (ESRD) fare better than children with ESRD from other causes while on dialysis, we conducted a cross-sectional study of children <18 years receiving peritoneal and hemodialysis in the United States using data from the Centers for Medicare & Medicaid Services 2005 ESRD CPM Project. We compared baseline demographics and the study groups. In multivariate logistic regression analysis of 1,286 subjects, we assessed whether children with urologic disorders had a higher odds of meeting adult KDOQI targets for hemoglobin levels ≥11 g/dl and albumin ≥3.5 BCG/3.2 BCP g/dl. We conducted a subset analysis of 1,136 patients to examine the impact of erythropoietin on hemoglobin targets. Our results did not reveal differences in achievement of adult hemoglobin targets (adjusted OR: 1.27; p value 0.09; CI: 0.97-1.66) or in the subset analysis with erythropoietin (adjusted OR: 1.32; p value 0.06; CI: 0.98-1.78) or albumin targets (adjusted OR: 1.22; p value 0.21; CI: 0.90-1.65) in adjusted analyses. Due to our study's limitations, it is difficult to determine whether this may result from treatment prior to dialysis initiation or treatment effect of dialysis rather than underlying diagnosis.
authors.affiliation: Division of Pediatric Nephrology, Johns Hopkins University, 200 N. Wolfe St., Baltimore, MD 21287, USA. rmlestz@gmail.com
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Lestz
authors.forename: Meredith
authors.initials: M
authors.lastname: Atkinson
authors.forename: Barbara
authors.initials: B
authors.lastname: Fivush
authors.forename: Susan L
authors.initials: SL
authors.lastname: Furth
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D014487:Centers for Medicare and Medicaid Services, U.S.; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome; D014481:United States; D014570:Urologic Diseases / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D012709:Serum Albumin; D004921:Erythropoietin