Renal replacement therapy (RRT) for children in Belarus 2007-2016. Analysis of anthropometric data of patients on dialysis and after kidney transplantation (Report of National Pediatric RRT Registry)

Despite the rarity of end-stage renal disease (ESRD) in children, it is a serious medical and social problem. Aim of the study was to assess the incidence and prevalence of ESRD in children in Belarus, age and sex of these patients, etiology of renal disease leading to ESRD and to determine the influence of the disease and methods of renal replacement therapy (RRT) on growth and anthropometric characteristics of the patients. Materials and methods: the study included 121 children who received RRT on 1 January 2007 and all subsequent new patients who started this therapy before 31 December 2016. Age at start of RRT was 11.4 (6.9; 14.9) years, 62,8% of children were boys. Results: the incidence of ESRD in children in Belarus aged 0-14 years, who started RRT in 2007-2016, was 7 (6; 8) cases per year or (4.8 (4.2; 5.2) per million age related population (pmarp); for the period 2009-2016 the incidence was 11 (9; 12) cases per year (5.6 (4.8; 6.8) pmarp). The prevalence of ESRD in children on RRT during the period from 2007 to 2016 increased by 31.7% in the group of 0-14 years: from 26 patients (18.3 pmarp) to 38 (24,1 pmarp), and by 51.7% aged 0-17 - from 37 (20.3 pmarp) to 57 (30.8 pmarp). The main cause of ESRD was congenital abnormality of kidney and urinary tract (44.6% cases). On December 31, 2016 75.4% of children were transplanted, 15.8% received peritoneal dialysis and 8.8% hemodialysis. 53 (43.8%) patients were transferred to adult service and 83% of them with a functioning graft. Mortality on RRT was 8.3%, 5-year mortality rate was 17.9 deaths per 1000 patient-years. SDS (standard deviation score) of height at the start of RRT was -1,16±1,74, SDS < -2 was found in 28.8% patients, more often at the age of 5-9 years (40.6%) and at 10-14 years (32.5 %). Improvement of growth depended not only on the age of transplantation, but also on the duration of graft functioning (r=0.55, p<0.01). 28% of children on RRT needed therapy with growth hormone. Conclusions: the incidence of ESRD in children in Belarus matches the average of ESPN/ERA-EDTA register, the prevalence is lower, but has a constant tendency to increase. There is a high number of transplants and low mortality of patients on RRT. It is necessary to introduce ESRD to the list of pathologies requiring the appointment of growth hormone in pediatric practice. Key words: end-stage renal disease (ESRD), the incidence, prevalence, mortality, transplantation, peritoneal dialysis, hemodialysis, growth, growth hormone

терминальная почечная недостаточность (тХПН), распространенность, летальность, трансплантация, перитонеальный диализ, гемодиализ, рост, гормон роста, end-stage renal disease (ESRD), the incidence, prevalence, mortality, transplantation, peritoneal dialysis, hemodialysis, growth, growth hormone

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