Clinical practice guidelines for the provision of renal service in Hong Kong: Potential Kidney Transplant Recipient Wait‐listing and Evaluation, Deceased Kidney Donor Evaluation, and Kidney Transplant Postoperative Care

Fung, Samuel; Chau, Kwong Wing; Chow, Kai Ming

doi:10.1111/nep.13502

Cited by 2 publications

(1 citation statement)

References 126 publications

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“…In Hong Kong, the public health care system, Hospital Authority, provides KRT with almost full subsidy and care for over 90% of patients with ESKD 6 . All patients suitable for transplantation, regardless of gender and ethnicity, would be considered for pre‐emptive living‐donor kidney transplant and are placed on the deceased kidney transplant waiting list on starting dialysis 15 . The allocation of deceased donor kidneys is based on a territory‐wide organ allocation system, taking into account of patients' age, number of mismatches with donor kidney, years on dialysis and medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Demographics and long‐term outcomes of children with end‐stage kidney disease: A 20‐year territory‐wide study

Chan¹,

Yap

Wong

et al. 2021

Nephrology

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Aim To evaluate the demographics and long‐term patient outcomes of children with end‐stage kidney disease in Hong Kong. Methods We conducted a cohort study at the Paediatric Nephrology Centre, the designated site providing kidney replacement therapy (KRT) for children in Hong Kong. The clinical characteristics and outcomes of all children who initiated chronic KRT before 19 years, between 2001 and 2020, were analysed. Results One hundred forty‐seven children (50% male) received KRT at a mean age of 11.4 ± 5.7 years. The incidence of ESKD was 6.28 per million age‐related population (pmarp). The leading cause of ESKD was congenital anomalies (33%). Ten children (7%) had pre‐emptive kidney transplants, 104 (71%) and 33 (22%) patients received automated peritoneal dialysis and haemodialysis as initial KRT. The incidence of ESKD increased over time, and were 4.38, 5.07, 6.15 and 9.17 pmarp during 2001–2005, 2006–2010, 2011–2015 and 2016–2020, respectively (p = .005). Ninty‐seven patients (66%) received kidney transplants and the median time to receive a kidney graft was 3.7 years (95% CI 3.1–4.3). Only 10 patients had pre‐emptive kidney transplants. The mortality rate was 9.1 deaths per 1000‐patient‐years (95%CI 4.6–16.2). The survival probabilities at 1‐, 5‐, 10‐ and 15‐year were 100%, 94.8% (95%CI 90.7–98.9%), 89.7% (95% CI 83.4%–95.9%), 87.1% (95% CI 79.3%–94.9%), respectively. Standardised mortality ratio was 54.5. 72% of deaths were due to infections. Young infants and those without kidney transplants were associated with worse survival (p < .01). Multivariate analysis demonstrated that dialysis was the only factor associated with significantly increased risk of death (HRadj 12.9, 95% CI 2.7–63.2, p = .002). Conclusion We observed an increasing incidence of paediatric ESKD in Hong Kong with considerable waiting time to kidney transplant. Mortality risk is comparable to other developed countries and is highest among dialysis population. Efforts should be made to facilitate early access to paediatric kidney transplantation in Hong Kong.

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Section: Discussionmentioning

confidence: 99%