The effects of hospital and dialysis unit characteristics on hospitalizations for access-related complications among children on maintenance dialysis: a European, multicenter, observational, cross-sectional study

Autor: Yeşim Özdemir Atikel, Claus Peter Schmitt, Eszter Lévai, Shazia Adalat, Rukshana Shroff, Nadine Goodman, İsmail Dursun, Ayşe Seda Pınarbaşı, Burcu Yazıcıoğlu, Fabio Paglialonga, Karel Vondrak, Isabella Guzzo, Nikoleta Printza, Aleksandra Zurowska, Ilona Zagożdżon, Aysun Karabay Bayazıt, Bahriye Atmış, Marcin Tkaczyk, Maria do Sameiro Faria, Ariane Zaloszyc, Augustina Jankauskiene, Mesiha Ekim, Alberto Edefonti, Sevcan A. Bakkaloğlu
Rok vydání: 2023
Předmět:
Zdroj: Pediatric Nephrology.
ISSN: 1432-198X
0931-041X
DOI: 10.1007/s00467-022-05842-5
Popis: © 2022, The Author(s), under exclusive licence to International Pediatric Nephrology Association.Background: Previous studies investigating hospitalizations in dialysis patients have focused primarily on patient-centered factors. We analyzed the impact of hospital and dialysis unit characteristics on pediatric dialysis patients’ hospitalizations for access-related complications (ARCs). Methods: This cross-sectional study involved 102 hemodialysis (HD) and 163 peritoneal dialysis (PD) patients. Data between July 2017 and July 2018 were analyzed. Results: Children’s hospitals (CHs) had more pediatric nephrologists and longer PD experience (years) than general hospitals (GHs) (p = 0.026 and p = 0.023, respectively). A total of 53% of automated PD (APD) and 6% of continuous ambulatory PD (CAPD) patients were in CHs (p < 0.001). Ninety-three percent of APD and 69% of CAPD patients were treated in pediatric-specific PD units (p = 0.001). CHs had a higher prevalence in providing hemodiafiltration (HDF) than GHs (83% vs. 30%). Ninety-seven percent of HDF vs. 66% for conventional HD (cHD) patients, and 94% of patients with arteriovenous fistula (AVF) vs. 70% of those with central venous catheters (CVC), were dialyzed in pediatric-specific HD units (p = 0.001 and p = 0.016, respectively). Eighty patients (51 PD and 29 HD) had 135 (84 PD, 51 HD) hospitalizations. CAPD was an independent risk factor for hospitalizations for infectious ARCs (I-ARCs) (p = 0.009), and a health center’s PD experience negatively correlated with CAPD patient hospitalizations for I-ARCs (p = 0.041). cHD and dialyzing in combined HD units significantly increased hospitalization risk for non-infectious (NI-)ARCs (p = 0.044 and p = 0.017, respectively). Conclusions: CHs and pediatric-specific dialysis units have higher prevalence of APD and HDF use. Hospitalizations for I-ARCs in CAPD are lower in centers with longer PD experience, and pediatric HD units are associated with fewer hospitalizations due to NI-ARCs. Graphical abstract: [Figure not available: see fulltext.]
Databáze: OpenAIRE
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