title: A Regional Evaluation of Survival of Infants with End-Stage Renal Disease.
abstract: BACKGROUND
  Information regarding morbidity and mortality of infants born with end-stage renal disease (ESRD) requiring dialysis early in life is critical to optimize patient care and better counsel families.
  
  
  OBJECTIVE
  We evaluated outcomes of infants born regionally with ESRD, and those within our broader catchment area referred for dialysis.
  
  
  METHODS
  We screened deaths at 5 regional referral hospitals, identifying infants with ESRD who did not survive to transfer for dialysis. We also screened all infants <8 weeks old seen at our institution over a 7-year period with ESRD referred for dialysis. We evaluated factors associated with survival to dialysis and transplant.
  
  
  RESULTS
  We identified 14 infants from regional hospitals who died prior to transfer and 12 infants at our institution who were dialyzed. Because of the large burden of lethal comorbidities in our regional referral centers, overall survival was low, with 73% dying at birth hospitals. Amongst dialyzed infants, 42% survived to transplant.
  
  
  CONCLUSIONS
  This study is unusual in reporting survival of infants with ESRD including those not referred for dialysis, which yields an expectedly lower survival rate than reported by dialysis registries.
authors.affiliation: Division of Nephrology, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Twichell
authors.forename: John
authors.initials: J
authors.lastname: Fiascone
authors.forename: Munish
authors.initials: M
authors.lastname: Gupta
authors.forename: Michael
authors.initials: M
authors.lastname: Prendergast
authors.forename: Nancy
authors.initials: N
authors.lastname: Rodig
authors.forename: Anne
authors.initials: A
authors.lastname: Hansen
mesh_terms: D001900:Boston / Q000453:epidemiology; D002391:Catchment Area, Health; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D010360:Patient Transfer; D012017:Referral and Consultation; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Infant; Neonatal intensive care; Neonate; Nephrology; Renal failure