End-stage renal disease requiring renal replacement therapy (RRT) during the neonatal period is a very rare condition, and little information is available regarding long-term RRT and outcomes. To gain more information, we performed a collaborative study on patient characteristics and treatment outcomes in children who started RRT as neonates during their first month of life between 2000 and 2011 who were prospectively registered in the ESPN/ERA-EDTA, the IPPN (since 2007), the Japanese registry, or the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry. During the first month of life, 264 patients from 32 countries started RRT and were followed for a median of 29 months (interquartile range 11-60 months). Most neonates (242) started on peritoneal dialysis, 21 started on hemodialysis, and 1 patient with a transplant. The most important causes of renal failure were congenital anomalies of the kidney and urinary tract in 141, cystic kidneys in 35, and cortical necrosis in 30. Within 2 years after the start of RRT, 69 children changed dialysis modality and 53 received a renal transplant. After a median of 7 months, 45 children had died, mainly because of infection, resulting in an estimated 2-year survival of 81%, and 5-year survival of 76%. Growth retardation (63%), anemia (55%), and hypertension (57%) were still major problems after 2 years. Thus, relatively good medium-term patient survival may be achieved with RRT started during the neonatal period, but specific therapeutic challenges continue to exist in this age group.

] Department for Pediatric Nephrology and Hypertension Medical University of Gdansk Gdansk Poland [2] Center for Pediatrics and Adolescent Medicine University of Heidelberg Heidelberg Germany

Bristol Royal Hospital for Children Bristol UK

Center for Pediatrics and Adolescent Medicine University of Heidelberg Heidelberg Germany

Centre de référence des maladies rénales rares Hospices Civils de Lyon and Université Claude Bernard Lyon 1 Lyon France

Children's Hospital University of Helsinki Helsinki Finland

Children's Mercy Hospital Kansas City Missouri USA

Department for Pediatric Nephrology and Hypertension Medical University of Gdansk Gdansk Poland

ESPN ERA EDTA Registry Academic Medical Center Amsterdam The Netherlands

Istituto Giannina Gaslini Genoa Italy

School of Women's and Children's Health University of New South Wales UNSW Medicine Sydney NSW Australia

Tokyo Metropolitan Children's Medical Center Tokyo Japan

University Hospital Prague Motol Prague Czech Republic

Kidney Int. 2014 Jul;86(1):18-20. doi: 10.1038/ki.2014.12. PubMed

References provided by Crossref.org

Survey of legislative frameworks and national recommendations governing paediatric maintenance haemodialysis in Europe

Nephrology and Public Policy Committee propositions to stimulate research collaboration in adults and children in Europe