Longitudinal analysis of intermediate outcomes in adolescent hemodialysis patients

Alicia M. Neu, Barbara A. Fivush, Bradley A. Warady, Sandy L. Watkins, Aaron L. Friedman, Andrew S. Brem, Stuart Goldstein, Diane L. Frankenfield

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

In 2000 and 2001, The Centers for Medicare & Medicaid Services (CMS) End-Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project collected data on all in-center hemodialysis (HD) patients in the United States aged ≥12 and <18 years. There were 433 of 486 (89%) patients and 435 of 516 (84%) patients who had the minimum required data submitted and were included in the 2000 and 2001 study years, respectively. There were 188 patients (43%) who had data submitted in both study years, providing longitudinal data on this cohort. A comparison of clinical parameters on these 188 patients in the 2000 and 2001 study years reveals significant improvement in mean calculated spKt/V (1.50±0.36 vs. 1.58±0.30, P<0.01), mean hemoglobin (11.0±1.6 g/dl vs. 11.5±1.3 g/dl, P<0.001), mean ferritin (286±278 ng/ml vs. 460±353 ng/ml, P<0.001 , mean transferrin saturation (27.8±15.1% vs. 31.3± 15.0%, P<0.05), mean serum albumin as measured by the bromocresol green method (3.83±0.54 g/dl vs. 3.95±0.42 g/dl, P<0.01), and mean height standard deviation score (-1.814±1.756 vs. -1.699±1.657, P<0.05). In addition, 20 of 29 (69%) patients who had a spKt/V <1.2 in the 2000 study year had a spKt/V >1.2 in the 2001 study year. Of 68 (44%) patients who had a catheter as their HD access in the 2000 study year, 30 had an arteriovenous fistula or graft in the 2001 study year and 49 of 80 (61%) patients who had a mean hemoglobin <11 g/dl in the 2000 study year had a hemoglobin >11 g/dl in the 2001 study year. In summary, these longitudinal data demonstrate significant improvements in nearly all clinical parameters studied in these adolescent HD patients.

Original languageEnglish (US)
Pages (from-to)1172-1176
Number of pages5
JournalPediatric Nephrology
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2003

Keywords

  • Access
  • Adolescent
  • Albumin
  • Clearance
  • Growth
  • Hemodialysis
  • Hemoglobin

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