title: Do children with end-stage renal disease live shorter? Analysis of mortality on the basis of data from the Polish Registry of Renal Replacement Therapy in Children.
abstract: OBJECTIVE
  The mortality of patients with end-stage renal disease (ESRD) is much higher than that of the general population. To date no data has been published on the mortality of children with ESRD in Poland. The aim of this study was to compare the risk of death for pediatric patients on renal replacement therapy (RRT) with that of the general pediatric population and to identify the risk factors of death.
  
  
  METHODS
  Data of 779 children with ESRD registered in the Polish Registry of Children on RRT was analyzed. The relative risk of death was calculated as the ratio of the mortality rate in ESRD patients to the mortality rate in age-adjusted general population.
  
  
  RESULTS
  The mortality rate of children with ESRD was 74-fold higher than that of the age- and gender-adjusted general pediatric population (4.05 vs. 0.05/100 person-years). The highest mortality rate (4.53/100 patient-years) was found in the youngest age group. Younger age and duration of dialysis therapy were identified as mortality risk factors. The major causes of death in ESRD patients were infections and cardiovascular complications, whereas deaths in general child population were mainly due to accidents or congenital defects.
  
  
  CONCLUSIONS
  The mortality in Polish children with ESRD is 74-fold higher than that of the general pediatric population. Infections, followed by cardiovascular complications, constitute the main causes of mortality in children subjected to RRT. The risk of death is the highest among children who started RRT at a younger age and in those subjected to long-term dialysis treatment.
authors.affiliation: Department Paediatrics, Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland. Electronic address: ilonazag@gumed.edu.pl.
authors.forename: Ilona
authors.initials: I
authors.lastname: Zagożdżon
authors.affiliation: Department Paediatrics, Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Żurowska
authors.affiliation: Department of Nephrology & Kidney Transplantation, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Sylwester
authors.initials: S
authors.lastname: Prokurat
authors.affiliation: Department of Nephrology & Kidney Transplantation, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rubik
authors.affiliation: Dialysis Unit, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Drożdż
authors.affiliation: Department and Clinic of Pediatrics, Nephrology and Endocrinology, Medical University of Silesia, Zabrze, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Szczepańska
authors.affiliation: Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Alfred
authors.initials: A
authors.lastname: Warzywoda
authors.affiliation: Nephrology Division, Department of Paediatrics and Immunology, Polish Mothers' Memorial Hospital Research Institute, Łodź, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Jander
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Helena
authors.initials: H
authors.lastname: Ziółkowska
authors.affiliation: Department of Pediatric Nephrology, Wrocław Medical University, Wrocław, Poland.
authors.forename: Irena
authors.initials: I
authors.lastname: Makulska
authors.affiliation: Department of Paediatric Nephrology, Medical University of Lublin, Lublin, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Bieniaś
authors.affiliation: Department of Nephrology, Children Hospital, Toruń, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Kipigroch
authors.affiliation: Department of Paediatrics and Nephrology, Medical University of Białystok, Białystok, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wierciński
authors.affiliation: Dialysis & Nephrology Unit, Regional Hospital in Rzeszów, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Siteń
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D011044:Poland; D017582:Renal Replacement Therapy
keywords: Chronic kidney disease; Mortality; Pediatrics; Renal replacement therapy