{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:06:03Z","timestamp":1760241963910,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2018,11,2]],"date-time":"2018-11-02T00:00:00Z","timestamp":1541116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Pediatric renal replacement therapy (RRT) in Lithuania resumed in 1994 after a 12-year pause in renal transplantation. Management of end stage renal disease (ESRD) has changed, and outcomes have improved over decades. Our aim was to evaluate the dynamics of RRT in Lithuania in the period 1994\u20132015, describe its distinctive features, and compare our results with other countries. Materials and Methods: Data between 1994 and 2015 were collected from patients under the age of 18 years with ESRD receiving RRT. The data included: Hemodialysis (HD), peritoneal dialysis (PD), transplantation incidence and prevalence, transplant waiting time, dialysis modalities before transplantation, causes of ESRD and gender distribution in transplanted patients, and patient and graft survival. Results: RRT incidence and prevalence maintained an increase up until 2009. Sixty-four transplantations were performed. Juvenile nephronophthisis (25.9%) was the primary cause of ESRD in transplanted children. The transplant waiting time median was 8.0 months. The male to female ratio post-transplantation was 1.02. Patient survival after transplantation at 10 years was 90.0%, while graft survival for living (related) was 77.0% and 51.1% for deceased. Twelve patients died while on RRT. Conclusions: RRT numbers are increasing in Lithuania. HD is the primary treatment of choice before transplantation, with continued low numbers of preemptive transplantation. Patient survival post-transplantation is favorable, though graft survival is less satisfactory.<\/jats:p>","DOI":"10.3390\/medicina54050078","type":"journal-article","created":{"date-parts":[[2018,11,5]],"date-time":"2018-11-05T04:26:39Z","timestamp":1541391999000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Renal Replacement Therapy in Children in Lithuania: Challenges, Trends, and Outcomes"],"prefix":"10.3390","volume":"54","author":[{"given":"Ernestas","family":"Vir\u0161ilas","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine, Vilnius University, LT-08406 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rimant\u0117","family":"\u010cerkauskien\u0117","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Vilnius University, LT-08406 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u016brat\u0117","family":"Masalskien\u0117","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0160ar\u016bnas","family":"Rudaitis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Dobilien\u0117","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustina","family":"Jankauskien\u0117","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Vilnius University, LT-08406 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1053\/j.ajkd.2013.09.011","article-title":"Survival trends in ESRD patients compared with the general population in the United States","volume":"63","author":"Manuel","year":"2014","journal-title":"Am. J. Kidney Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1007\/s11255-012-0322-x","article-title":"Views of Japanese patients on the advantages and disadvantages of hemodialysis and peritoneal dialysis","volume":"45","author":"Muranaka","year":"2013","journal-title":"Int. Urol. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3047","DOI":"10.1016\/j.transproceed.2007.09.030","article-title":"Quality of Life in Hemodialysis, Peritoneal Dialysis, and Transplantation Patients","volume":"39","author":"Sayin","year":"2007","journal-title":"Transplant. Proc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1097\/01.ASN.0000091585.45723.9E","article-title":"Hemodialysis and peritoneal dialysis: Comparison of adjusted mortality rates according to the duration of dialysis: Analysis of The Netherlands Cooperative Study on the Adequacy of Dialysis 2","volume":"14","author":"Termorshuizen","year":"2003","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_5","unstructured":"ESPN\/ERA-EDTA (2017, February 21). Update on Registry\u2014December 2016. Available online: https:\/\/www.espn-reg.org\/files\/AR2014_Final.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/s10157-014-1077-8","article-title":"End-stage renal disease in Japanese children: A nationwide survey during 2006\u20132011","volume":"19","author":"Hattori","year":"2015","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_7","unstructured":"(2010). Treatment Modalities. U.S. Renal Data System, USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00467-015-3263-7","article-title":"Inequalities in access to pediatric ESRD care: A global health challenge","volume":"31","author":"Harambat","year":"2016","journal-title":"Pediatr. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/ckj\/sfw047","article-title":"Chronic kidney disease in children","volume":"9","author":"Becherucci","year":"2016","journal-title":"Clin. Kidney J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1111\/ajt.12288","article-title":"Disparities in policies, practices and rates of pediatric kidney transplantation in Europe","volume":"13","author":"Harambat","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1093\/ndt\/gfv064","article-title":"Disparities in treatment rates of paediatric end-stage renal disease across Europe: Insights from the ESPN\/ERA-EDTA registry","volume":"30","author":"Chesnaye","year":"2015","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1007\/s00467-014-2884-6","article-title":"Demographics of paediatric renal replacement therapy in Europe: A report of the ESPN\/ERA-EDTA registry","volume":"29","author":"Chesnaye","year":"2014","journal-title":"Pediatr. Nephrol."},{"key":"ref_13","unstructured":"(2016, November 17). Paediatric Working Group, ANZDATA Annual Report: Chapter 11 Paediatrics. Available online: http:\/\/www.anzdata.org.au\/anzdata\/AnzdataReport\/37thReport\/c11_paediatric_print_20150929.pdf."},{"key":"ref_14","unstructured":"National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (2015). United States Renal Data System. 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.transproceed.2010.02.031","article-title":"Indications for and barriers to preemptive kidney transplantation: A review","volume":"42","author":"Kallab","year":"2010","journal-title":"Transplant. Proc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1093\/ndt\/gfv378","article-title":"Does pre-emptive transplantation versus post start of dialysis transplantation with a kidney from a living donor improve outcomes after transplantation? A systematic literature review and position statement by the Descartes Working Group and ERBP","volume":"31","author":"Abramowicz","year":"2016","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.kint.2016.07.028","article-title":"Preemptive kidney transplantation is associated with survival benefits among pediatric patients with end-stage renal disease","volume":"90","author":"Amaral","year":"2016","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"239515","DOI":"10.4061\/2011\/239515","article-title":"In Peritoneal Dialysis, Is There Sufficient Evidence to Make \u201cPD First\u201d Therapy?","volume":"2011","author":"Dalal","year":"2011","journal-title":"Int. J. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s00467-011-1939-1","article-title":"Epidemiology of chronic kidney disease in children","volume":"27","author":"Harambat","year":"2012","journal-title":"Pediatr. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s00467-006-0410-1","article-title":"Chronic kidney disease in children: The global perspective","volume":"22","author":"Warady","year":"2007","journal-title":"Pediatr. Nephrol."},{"key":"ref_21","first-page":"1","article-title":"Long-term effects of paediatric kidney transplantation","volume":"12","author":"Holmberg","year":"2015","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_22","unstructured":"Canadian Institute for Health Information (2016, November 17). Canadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada, 2004 to 2013. Available online: https:\/\/secure.cihi.ca\/free_products\/2011_CORR_Annua_Report_EN.pdf."},{"key":"ref_23","first-page":"1","article-title":"ESPN\/ERA-EDTA Registry Study Group. Racial Disparities in Access to and Outcomes of Kidney Transplantation in Children, Adolescents, and Young Adults: Results From the ESPN\/ERA-EDTA (European Society of Pediatric Nephrology\/European Renal Association\u2013European Dialysis and Transplant Association","volume":"67","author":"Tjaden","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2659","DOI":"10.1097\/MD.0000000000002659","article-title":"Incidence and Risks of Congenital Anomalies of Kidney and Urinary Tract in Newborns: A Population-Based Case-Control Study in Taiwan","volume":"95","author":"Tain","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1542\/peds.2013-2775","article-title":"National trends over 25 years in pediatric kidney transplant outcomes","volume":"133","author":"Boyarsky","year":"2014","journal-title":"Pediatrics"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Rees, L., Shroff, R., Hutchinson, C., Fernando, O.N., and Trompeter, R.S. (2007). Long-term outcome of paediatric renal transplantation: Follow-up of 300 children from 1973 to 2000. Nephron Clin. Pract., 105.","DOI":"10.1159\/000097601"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/ndt\/gfq730","article-title":"Kidney allograft survival: The long and short of it","volume":"26","author":"Lodhi","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/ajt.12579","article-title":"OPTN\/SRTR 2012 Annual Data Report: Kidney","volume":"14","author":"Matas","year":"2014","journal-title":"Am. J. Transplant."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1053\/j.ackd.2016.07.001","article-title":"Current Status of Kidney Transplant Outcomes: Dying to Survive","volume":"23","author":"Wang","year":"2016","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.2215\/CJN.00950208","article-title":"Aspects of immune dysfunction in end-stage renal disease","volume":"3","author":"Kato","year":"2008","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000356086","article-title":"Stroke in dialysis and chronic kidney disease","volume":"36","author":"Power","year":"2014","journal-title":"Blood Purif."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00467-007-0559-2","article-title":"Long-term outcome after renal transplantation in childhood","volume":"24","author":"Rees","year":"2009","journal-title":"Pediatr. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1046\/j.1523-1755.2002.00156.x","article-title":"Mortality and causes of death of end-stage renal disease in children: A Dutch cohort study","volume":"61","author":"Groothoff","year":"2002","journal-title":"Kidney Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/54\/5\/78\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:27:42Z","timestamp":1760196462000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/54\/5\/78"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,2]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,11]]}},"alternative-id":["medicina54050078"],"URL":"https:\/\/doi.org\/10.3390\/medicina54050078","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2018,11,2]]}}}