title: Survival analysis of pediatric dialysis patients in Taiwan.
abstract: OBJECTIVE
  The long-term survival of Taiwanese children with end-stage renal disease (ESRD) has not been reported before. This study aimed to determine the long-term survival, mortality hazards and causes of death in paediatric patients receiving dialysis.
  
  
  METHODS
  Paediatric patients (aged 19 years and younger) with incident ESRD who were reported to the Taiwan Renal Registry from 1995 to 2004 were included. A total of 319 haemodialysis (HD) and 156 peritoneal dialysis (PD) patients formed the database. After stratification by dialysis modality, multivariate Cox proportional-hazards model was constructed with age, sex and co-morbidity as predictive variables.
  
  
  RESULTS
  The annual paediatric ESRD incidence rate was 8.12 per million of age-related populations. The overall 1-, 5-, and 10-year survival rates for PD patients were 98.1%, 88.0% and 68.4%, respectively, and were 96.9%, 87.3% and 78.5% for HD patients. The survival analysis showed no significant difference between HD and PD (P = 0.4878). Using '15-19 years' as a reference group, the relative risk (RR) of the youngest group (0-4 years) was 6.60 (95% CI: 2.50-17.38) for HD, and 5.03 (95% CI: 1.23-20.67) for PD. The death rate was 24.66 per 1000 dialysis patient-years. The three major causes of death were infection (23.4%), cardiovascular disease (13.0%) and cerebrovascular disease (10.4%). Hemorrhagic stroke (87.5%) was the main type of foetal cerebrovascular accident.
  
  
  CONCLUSIONS
  We conclude that there was no significant difference of paediatric ESRD patient survival between HD and PD treatment in Taiwan. The older paediatric ESRD patients had better survival than younger patients.
authors.affiliation: The Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Ching-Wei
authors.initials: CW
authors.lastname: Tsai
authors.forename: Pao-Hsuan
authors.initials: PH
authors.lastname: Lin
authors.forename: Kuang-Fu
authors.initials: KF
authors.lastname: Cheng
authors.forename: Hong-Dar
authors.initials: HD
authors.lastname: Wu
authors.forename: I-Kwan
authors.initials: IK
authors.lastname: Wang
authors.forename: Ching-Yuang
authors.initials: CY
authors.lastname: Lin
authors.forename: Walter
authors.initials: W
authors.lastname: Chen
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002423:Cause of Death; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality*; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult