Mortality in Children with End Stage Renal Disease and Kidney Transplantation

Objectives. This study investigated the risk of mortality for children receiving kidney transplantation. Methods. From the Taiwan National Health Insurance claims data of 1998-2009, we identified children with hemodialysis (HD) and periodontal dialysis (PD) and later receiving kidney transplantation . Mortality rates in children with kidney transplantation were compared by baseline dialysis status and comorbidity before the transplantation. Results. The transplantation rates were similar between children receiving HD (86/393, 21.8%) and PD (46/219, 21.0%). Both groups of patients were more prevalent with hypertension (67.2% vs. 66.2%, respectively) and infection (45.0% vs. 47.0%, respectively) than with diabetes (4.58% vs. 0.46%, respectively). The mortality rate in children with kidney transplantation was 1.98-fold greater in the PD group than in the HD group (5.08 vs. 2.56 per 100 person-years) with the Cox model measured HR of 1.58 (95% CI 1.19 = 2.08) after controlling for demographic factors and comorbidity. Patients with hypertension and infection were at higher risk of mortality. Conclusion. Among children with kidney transplantation, those in the PD group are at a higher mortality risk than those in the HD group. Hypertension and infection may also contribute to the mortality risk.