Background

Sociocultural issues play a key role in children needing kidney replacement therapy (KRT).

Methods

Data of incident patients < 18 years treated with chronic dialysis or preemptive kidney transplantation (pTx) between 2007 and 2016 were retrospectively collected from the Italian Pediatric Dialysis Registry; KRT modality and outcome were compared between patients with at least one non-Italian parent (“resident foreign patients,” RFPs) and those from native parents (“domestic patients,” DPs) and between the quinquennium 2007–2011 (period 1) and 2012–2016 (period 2).

Results

We included 448 children (26.8% RFPs). The percentage of RFPs increased from 23 to 30.3% (p = 0.08) from periods 1 to 2. They were younger (6.7 vs. 9.4 years, p = 0.025) and less often treated with pTx (3.3 vs. 13.4%, p = 0.009) than DPs. The percentage of pTx increased from period 1 to 2 in RFPs only (8.4–18.6%, p = 0.006). Independent predictors of a lower probability of pTx were lower age, belonging to RFPs group, starting KRT in period 1 and focal segmental glomerulosclerosis or glomerulopathy as primary kidney disease. Peritoneal dialysis was the preferred dialysis modality in both groups. Age, primary kidney disease, and center size were independently associated with dialysis modality choice. Patient survival, waiting time to Tx, and dialysis modality survival were not different between the two groups.

Conclusions

The proportion of patients receiving KRT born from immigrant families increased in recent years in Italy. They were younger and less often treated with pTx than domestic patients. In case of dialysis, the outcome was not different between the two groups.

中文翻译：

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常驻外国患者接受充分透析，但抢先移植较少：来自意大利儿科透析登记处的数据。

背景

社会文化问题在需要肾脏替代疗法 (KRT) 的儿童中起着关键作用。

方法

从意大利儿科透析登记处回顾性收集了 2007 年至 2016 年间接受慢性透析或先行性肾移植 (pTx) 治疗的 18 岁以下患者的数据；KRT 模式和结果在至少有一个非意大利父母的患者（“常驻外国患者”RFP）和来自本土父母的患者（“国内患者”，DP）之间以及 2007-2011 年（第 1 期）和2012-2016 年（第 2 期）。

结果

我们纳入了 448 名儿童（26.8% 的 RFP）。从第 1 期到第 2 期，RFP 的百分比从 23% 增加到 30.3% ( p = 0.08)。他们更年轻（6.7 岁 vs. 9.4 岁，p  = 0.025）并且较少接受 pTx 治疗（3.3% 对 13.4%，p  = 0.009) 比 DP。仅在 RFP 中，pTx 的百分比从第 1 期增加到第 2 期（8.4-18.6%，p = 0.006）。pTx 发生概率较低的独立预测因素是年龄较低、属于 RFP 组、在第 1 期开始 KRT 以及局灶节段性肾小球硬化或肾小球病作为原发性肾脏疾病。腹膜透析是两组的首选透析方式。年龄、原发性肾脏疾病和中心规模与透析方式的选择独立相关。两组患者的生存率、等待 Tx 的时间和透析方式的生存率没有差异。

结论

近年来，意大利接受来自移民家庭的 KRT 患者的比例有所增加。与国内患者相比，他们更年轻，接受 pTx 治疗的频率也更低。在透析的情况下，两组之间的结果没有差异。