Longitudinal analysis of intermediate outcomes in adolescent hemodialysis patients |
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Authors: | Email author" target="_blank">Alicia?M?NeuEmail author Barbara?A?Fivush Bradley?A?Warady Sandra?L?Watkins Aaron?L?Friedman Andrew?S?Brem Stuart?Goldstein Diane?L?Frankenfield |
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Institution: | (1) Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;(2) The Children's Mercy Hospital, Kansas City, Missouri, USA;(3) University of Washington, Children's Hospital, Seattle, Washington, USA;(4) University of Wisconsin, Children's Hospital, Madison, Wisconsin, USA;(5) Rhode Island Hospital, Providence, Rhode Island, USA;(6) Baylor College of Medicine, Houston, Texas, USA;(7) The Centers for Medicare & Medicaid Services (CMS), Center for Beneficiary Choices, Baltimore, Maryland, USA;(8) Department of Pediatric Nephrology, Johns Hopkins University, 600 N. Wolfe Street/Park 327, Baltimore, MD 21287–2535, USA |
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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 >or=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. |
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Keywords: | Hemodialysis Adolescent Clearance Hemoglobin Access Albumin Growth |
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