Children on chronic hemodialysis before the first year of age in Brazil: A 3-year survival analysis

Introduction: The limited data on survival rates of small children undergoing hemodialysis preclude comparison with other countries. The goal of this study was to determine the mortality rate and its risk factors in children starting hemodialysis during their first year of life. Methods: We performed a retrospective cohort study, based on data from a reference dialysis center in Sao Paulo city. Data from 47 (8 females) children who underwent chronic hemodialysis before the first year of age were analyzed. Survival was characterized using Kaplan-Meier methods and log-rank tests, followed by a multivariable Cox regression model. Results: The survival rates were 93%, 75%, and 64% at 1, 2, and 3 years, respectively. Only cardiovascular comorbidity was significantly associated with the mortality outcome (HR = 5.7, 95% CI = 1.7-19.6, p = 0.006). Conclusion: The survival rate among children who started hemodialysis in their first year of life was reasonable, similar to international standards.