UK Renal Registry 20th Annual Report Chapter 4 Demography of the UK Paediatric Renal Replacement Therapy Population in 2016

In 2016, 964 children and young people aged less than 18 years were receiving long-term renal replacement therapy (RRT) for established renal failure (ERF) at UK paediatric nephrology centres. A total of 125 incident patients under 18 years commenced RRT. At the census date (31 December 2016), 77% of prevalent paediatric patients aged <16 years had a functioning kidney transplant (43% live and 34% deceased donor), 12% were receiving haemodialysis (HD) and 11% were receiving peritoneal dialysis (PD). In 2016, the prevalence of ERF in patients aged less than 16 years was 64.1 per million age-related population (pmarp). The incidence of ERF for 2016 was 9.0 pmarp. Using ERA-EDTA Registry classification, tubulo-interstitial disease (which includes congenital structural anomalies) accounted for over half of all primary renal diagnoses in prevalent patients, with a high male: female ratio (3.3 : 1). Over time, there has been a progressive decline in glomerular disease as a primary renal cause of ERF. Between 2002 and 2016, a third of prevalent children in ERF aged three months to 16 years who were referred early received a pre-emptive transplant. Males and White ethnic children were significantly more likely to benefit from pre-emptive transplantation, adjusting for time-period, age at RRT start and primary renal diagnosis. At the time of transfer to adult services, 89.4% of patients had a functioning kidney transplant.