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. 1988 Feb;63(2):120–126. doi: 10.1136/adc.63.2.120

End stage renal failure: 14 years' experience of dialysis and renal transplantation.

G Offner 1, C Aschendorff 1, P F Hoyer 1, H P Krohn 1, J H Ehrich 1, R Pichlmayr 1, J Brodehl 1
PMCID: PMC1778716  PMID: 3279923

Abstract

One hundred and thirteen children (59 boys and 54 girls aged from 2 to 16 years) with end stage renal failure entered the renal dialysis and transplantation programme between 1972 and 1983. They were followed up until December 1985. Ninety eight children were initially treated by haemodialysis in hospital and 15 by renal transplantation. The average wait on dialysis was seven months (range 0.1-43 months). One hundred and six children were given 129 renal transplants, 32 of which were from living related donors. At the end of 1985 94 of the 113 patients (83%) were alive, 81 (72%) with functioning grafts, 11 (10%) were receiving haemodialysis in hospital, two (1%) were being treated by continuous ambulatory peritoneal dialysis, and three had been lost to follow up. The 14 years actuarial survival was 81%. Four patients receiving dialysis and 12 who had received transplants died, a mortality of 14%. The main complications of treatment were retardation of growth in 49 (43%), hypertension in 75 (66%), and osteopathy in 36 (32%). Retardation of growth could not be reversed by successful renal transplantation. Seventy two patients (88%) assessed their health as good to excellent, and 9 (12%) as poor. Patients with a functioning graft did much better than those receiving dialysis. Treatment of end stage renal failure led to full rehabilitation in most patients, and renal transplantation was more effective than dialysis.

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Selected References

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  1. Broyer M., Gagnadoux M. F., Guest G., Beurton D., Niaudet P., Habib R., Busson M. Kidney transplantation in children: results of 383 grafts performed at Enfants Malades Hospital from 1973 to 1984. Adv Nephrol Necker Hosp. 1987;16:307–333. [PubMed] [Google Scholar]
  2. Broyer M., Guest G., Gagnadoux M. F., Beurton D. Hypertension following renal transplantation in children. Pediatr Nephrol. 1987 Jan;1(1):16–21. doi: 10.1007/BF00866879. [DOI] [PubMed] [Google Scholar]
  3. Chantler C., Carter J. E., Bewick M., Counahan R., Cameron J. S., Ogg C. S., Williams D. G., Winder E. 10 years' experience with regular haemodialysis and renal transplantation. Arch Dis Child. 1980 Jun;55(6):435–445. doi: 10.1136/adc.55.6.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Conley S. B., Flechner S. M., Rose G., Van Buren C. T., Brewer E., Kahan B. D. Use of cyclosporine in pediatric renal transplant recipients. J Pediatr. 1985 Jan;106(1):45–49. doi: 10.1016/s0022-3476(85)80462-5. [DOI] [PubMed] [Google Scholar]
  5. Fine R. N., Salusky I. B. CAPD/CCPD in children: four years' experience. Kidney Int Suppl. 1986 Jul;19:S7–10. [PubMed] [Google Scholar]
  6. Hoyer P. F., Krohn H. P., Offner G., Byrd D. J., Brodehl J., Wonigeit K., Pichlmayr R. Renal function after kidney transplantation in children. A comparison of conventional immunosuppression with cyclosporine. Transplantation. 1987 Apr;43(4):489–493. doi: 10.1097/00007890-198704000-00006. [DOI] [PubMed] [Google Scholar]
  7. Hoyer P. F., Offner G., Brodehl J. Acute rejection episodes after renal transplantation in children. Clin Nephrol. 1983 Feb;19(2):61–66. [PubMed] [Google Scholar]
  8. Hoyer P. F., Offner G., Wonigeit K., Brodehl J., Pichlmayr R. Dosage of Cyclosporin A in children with renal transplants. Clin Nephrol. 1984 Aug;22(2):68–71. [PubMed] [Google Scholar]
  9. Jones R. W., Rigden S. P., Barratt T. M., Chantler C. The effects of chronic renal failure in infancy on growth, nutritional status and body composition. Pediatr Res. 1982 Sep;16(9):784–791. doi: 10.1203/00006450-198209000-00016. [DOI] [PubMed] [Google Scholar]
  10. Kleinknecht C., Broyer M., Gagnadoux M. F., Martihenneberg C., Dartois A. M., Kermanach C., Pouliquen M., Degoulet P., Usberti M., Roy M. P. Growth in children treated with long-term dialysis. A study of 76 patients. Adv Nephrol Necker Hosp. 1980;9:133–163. [PubMed] [Google Scholar]
  11. Offner G., Brodehl J., Galaske R., Rutt T. Acute renal failure in children: prognostic features after treatment with acute dialysis. Eur J Pediatr. 1986 Feb;144(5):482–486. doi: 10.1007/BF00441743. [DOI] [PubMed] [Google Scholar]
  12. Offner G., Hoyer P. F., Jüppner H., Krohn H. P., Brodehl J. Somatic growth after kidney transplantation. Beneficial effect of cyclosporine in comparison with conventional immunosuppression. Am J Dis Child. 1987 May;141(5):541–546. doi: 10.1001/archpedi.1987.04460050083036. [DOI] [PubMed] [Google Scholar]
  13. Pistor K., Olbing H., Schärer K. Children with chronic renal failure in the Federal Republic of Germany: I. Epidemiology, modes of treatment, survival. Arbeits- gemeinschaft für Pädiatrische Nephrologie. Clin Nephrol. 1985 Jun;23(6):272–277. [PubMed] [Google Scholar]
  14. Potter D. E., Holliday M. A., Piel C. F., Feduska N. J., Belzer F. O., Salvatierra O., Jr Treatment of end-stage renal disease in children: a 15-year experience. Kidney Int. 1980 Jul;18(1):103–109. doi: 10.1038/ki.1980.115. [DOI] [PubMed] [Google Scholar]
  15. Potter D., Feduska N., Melzer J., Garovoy M., Hopper S., Duca R., Salvatierra O., Jr Twenty years of renal transplantation in children. Pediatrics. 1986 Apr;77(4):465–470. [PubMed] [Google Scholar]
  16. Tanner J. M., Whitehouse R. H. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child. 1976 Mar;51(3):170–179. doi: 10.1136/adc.51.3.170. [DOI] [PMC free article] [PubMed] [Google Scholar]

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