BACKGROUND Data on long-term outcomes in children who have received renal replacement therapy (RRT) for end-stage renal disease are limited. METHODS We studied long-term survival and incidence of fatal and nonfatal cardiovascular disease (CVD) events and determinants of these outcomes in children who initiated RRT between 1961 and 2013 using data from the Scottish Renal Registry (SRR). Linkage to morbidity records was available from 1981. RESULTS A total of 477 children of whom 55% were boys, almost 50% had congenital urinary tract disease (CAKUT), 10% received a transplant as the first mode of RRT and almost 60% were over 11 years of age at start of RRT were followed for a median of 17.8 years (interquartile range (IQR) 8.7-26.6 years). Survival was 87.3% (95% confidence interval (CI) 84.0-90.1) at 10 years and 77.6% (95% CI 73.3-81.7) at 20 years. During a median follow-up of 14.96 years (IQR 7.1-22.9), 20.9% of the 381 patients with morbidity data available had an incident of CVD event. Age < 2 years at start of RRT, receiving dialysis rather than a kidney transplant and primary renal disease (PRD) other than CAKUT or glomerulonephritis (GN), were associated with a higher risk of all-cause mortality. Male sex, receiving dialysis rather than a kidney transplant and PRD other than CAKUT or GN, was associated with a higher risk of CVD incidence. CONCLUSIONS Mortality and CVD incidence among children receiving RRT are high. PRD and RRT modality were associated with increased risk of both all-cause mortality and CVD incidence.

中文翻译：

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苏格兰儿童开始肾脏替代治疗后的长期全因死亡率和心血管结局：一项全国队列研究。

背景 关于接受肾脏替代疗法（RRT）治疗终末期肾病的儿童的长期结果的数据有限。方法 我们使用苏格兰肾脏登记处 (SRR) 的数据，研究了 1961 年至 2013 年间开始 RRT 的儿童的长期生存率、致命性和非致命性心血管疾病 (CVD) 事件的发生率以及这些结果的决定因素。从 1981 年起就可以获得与发病率记录的联系。 结果 共有 477 名儿童，其中 55% 是男孩，近 50% 患有先天性尿路疾病 (CAKUT)，10% 接受移植作为 RRT 的第一种模式，近 60% 患有先天性尿路疾病 (CAKUT)。开始 RRT 时年龄超过 11 岁的患者的随访时间中位数为 17.8 年（四分位距 (IQR) 8.7-26.6 年）。10 年生存率为 87.3%（95% 置信区间 (CI) 84.0-90.1），20 年生存率为 77.6%（95% CI 73.3-81.7）。在中位随访 14.96 年（IQR 7.1-22.9）期间，381 名有发病率数据的患者中有 20.9% 发生过 CVD 事件。RRT 开始时年龄 < 2 岁、接受透析而不是肾移植以及除 CAKUT 或肾小球肾炎 (GN) 之外的原发性肾脏疾病 (PRD) 与全因死亡风险较高相关。接受透析而不是肾移植以及除 CAKUT 或 GN 之外的 PRD 的男性与较高的 CVD 发病风险相关。结论 接受 RRT 的儿童死亡率和 CVD 发病率较高。PRD 和 RRT 方式与全因死亡率和 CVD 发病率风险增加相关。