Evidence map›Paper›PMID 42104990›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Trends in chronic dialysis practices and outcomes in North American children: a 30-year NAPRTCS registry analysis.

Ankana Daga, Kathleen Altemose, Sarah Twichell, Shina Menon, Rebecca L Ruebner, Raj Munshi, Sarah J Swartz, Sara Boynton, Michael J G Somers

Abstract read
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Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ankana DagaDivision of Nephrology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. ankana.daga@childrens.harvard.edu.ORCID http://orcid.org/0000-0002-9217-2648
Kathleen AltemoseDivision of Pediatric Nephrology, Department of Pediatrics, Central Michigan University, Saginaw, MI, USA.
Sarah TwichellDepartment of Pediatrics, Golisano Children's Hospital at the University of Vermont, Burlington, VT, USA.
Shina MenonDivision of Nephrology, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
Rebecca L RuebnerDivision of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Raj MunshiDepartment of Pediatric Nephrology, Seattle Children's and University of Washington, Seattle, WA, USA.
Sarah J SwartzDivision of Pediatric Nephrology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Sara BoyntonDivision of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Michael J G SomersDivision of Nephrology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) registry has tracked outcomes of children receiving maintenance dialysis since 1992.

methodsWe analyzed 8923 incident pediatric dialysis patients enrolled from 1992 to 2020, grouped into three eras (1992-2000, 2001-2010, 2011-2020). Demographics, primary diagnoses, dialysis modality, survival, causes of death, and time to kidney transplant were assessed.

resultsThe cohort was 56% male and 49% White. The most common causes of kidney failure were hypoplasia/dysplasia (15%), focal segmental glomerulosclerosis (14%), and obstructive uropathy (12%). Dialysis practices changed over time, with peritoneal dialysis (PD) declining as the initial modality from 66% in the 1990s to 40% in 2011-2020, while hemodialysis (HD) increased correspondingly. Infants represented an increasing proportion of patients initiating dialysis, rising from 15% in the 1990s to 25% in the most recent era. Three-year survival improved between the first and second eras to 90% but has remained stable in the past decade (91%). Infants had the lowest survival (77%). Among 734 deaths, cardiopulmonary causes remained stable across eras (22%), whereas infection-related mortality declined from 22 to 15% and occurred more frequently in PD than HD (23% vs. 12%, p < 0.05). 90% of children listed received a kidney transplant, and this was the most common cause of dialysis discontinuation.

conclusionsOver time survival on dialysis has improved, though survival rates have recently been relatively static. Cardiopulmonary causes of death have not shown a decrease in prevalence across dialysis eras.

Indexed as

Kidney Failure, ChronicRenal DialysisAdolescentCause of DeathChildChild, PreschoolFemaleHumansInfantInfant, NewbornKidney TransplantationMaleNorth AmericaPeritoneal DialysisRegistriesTreatment OutcomeChildrenHemodialysisKidney failurePediatric dialysisPeritoneal dialysisStage 5 chronic kidney disease

Identifiers

PMID42104990

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.