1. Chapter 7: Pediatric ESRD 2014 A NNUAL D ATA R EPORT V OLUME 2: E ND -S TAGE R ENAL D ISEASE

2. Vol 2, ESRD, Ch 72 Data Source: Reference tables D3-D5, D7-D9, and special analyses, USRDS ESRD Database. Peritoneal dialysis consists of continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. Abbreviations: ESRD, end-stage renal disease; HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.1. Incident & December 31 point prevalent ESRD patients (aged 0-19 years) (a) Incidence of ESRD in children

3. Vol 2, ESRD, Ch 73 Data Source: Reference tables D3-D5, D7-D9, and special analyses, USRDS ESRD Database. Peritoneal dialysis consists of continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. Abbreviations: ESRD, end-stage renal disease; HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.1. Incident & December 31 point prevalent ESRD patients (aged 0-19 years) (b) Prevalence of ESRD in children

4. Vol 2, ESRD, Ch 74 vol 2 Table 7.1 : Distribution of reported incident pediatric ESRD patients by primary diagnosis, 2003-2007 (period A) and 2008-2012 (period B) (aged 0-19 years) TransplantDied TotalIncidentAgeMaleWhiteAfrican AmOther Racefirst year Patients %Median%% % A B A B A B A B A B A B A B A B A B All ESRD (reference) 6,544 6,204100.0 14 57.056.564.365.724.723.011.011.341.443.63.73.3 Diabetes 58 570.91.0181646.652.655.257.937.936.86.95.38.615.812.112.3 Type 2 30 340.50.615453.352.956.761.830.032.413.35.913.38.810.017.6 Type 1 28 230.4 19 39.352.253.652.246.443.50.04.33.626.114.34.3 Glomerulonephritis (GN) 1,541 1,33624.723.016 54.952.858.564.133.229.08.46.935.436.52.21.7 GN (histologically not examined) 275 1944.43.3171857.856.761.169.626.520.612.49.829.525.33.61.5 Focal glomerular sclerosis 824 72113.212.415 56.854.451.859.242.036.16.24.737.639.41.9 Membranous nephropathy 31 340.50.6151748.458.858.147.132.344.19.78.835.541.20.0 MPGN GN type 1, diffuse MPGN 77 751.21.3151648.148.076.666.714.324.09.19.340.342.72.64.0 Dense deposit disease, MPGN type 2 26 200.40.3121538.560.096.275.03.810.00.015.030.820.03.80.0 IgA nephropathy 130 1342.12.317 58.554.568.576.119.213.412.310.440.844.00.80.0 IgM nephropathy * 140.10.2161857.164.342.971.442.921.414.37.142.914.30.0 Rapidly progressive GN 77 561.21.014 45.523.266.275.022.116.111.78.927.321.42.61.8 Post infectious GN, SBE 14 210.20.4141664.352.457.171.428.623.814.34.821.414.30.04.8 Other proliferative GN 80 671.31.2151641.343.366.365.726.326.97.5 31.343.32.51.5 Secondary GN/vasculitis 708 65611.411.316 31.829.354.057.836.735.29.37.014.718.14.54.3 Lupus nephritis 405 3326.55.7171822.721.738.332.850.459.011.48.16.97.25.94.5 Henoch-Schonlein syndrome 23 280.40.5151465.253.687.085.74.37.18.77.143.539.30.03.6 Scleroderma * *0.1 18 25.066.750.066.750.033.30.0 33.325.033.3 Hemolytic uremic syndrome 119 1131.9 6847.137.277.382.317.612.45.05.327.735.43.44.4 Polyarteritis 11 210.20.4141318.219.072.785.79.14.818.29.59.119.00.0 Wegeners granulomatosis 60 561.0 151656.742.970.089.323.37.16.73.620.023.23.31.8 Other vasculitis and its derivatives 58 540.9 151325.933.369.072.225.916.75.211.124.129.61.75.6 Goodpasture syndrome 14 330.20.6161728.627.385.793.97.13.07.13.021.418.20.03.0 Secondary GN, other 14 160.20.3141742.937.578.681.37.118.814.30.021.425.00.06.3

5. Vol 2, ESRD, Ch 75 TransplantDied TotalIncidentAgeMaleWhiteAfrican AmOther Racefirst year Patients %Median%% % A B A B A B A B A B A B A B A B A B Interstitial nephritis/pyelonephritis 391 2896.35.015 52.750.981.3 12.811.15.97.647.854.72.04.8 Nephropathy caused by other agents 41 370.70.6151456.156.882.983.814.610.82.45.453.729.79.810.8 Nephrolithiasis * 110.10.2121644.427.3100.090.90.0 9.1100.081.80.09.1 Acquired obstructive uropathy 48 300.80.5151477.176.766.780.022.916.710.43.345.846.70.0 Chronic pyelonephritis, reflux nephropathy 201 1433.22.515 44.345.588.684.66.57.05.08.448.360.80.52.8 Chronic interstitial nephritis 75 601.21.0141657.346.773.3 20.016.76.710.046.756.72.73.3 Acute interstitial nephritis * *0.00.111 33.3100.033.350.066.750.00.0 50.00.050.0 Disorders of calcium metabolism *.0.1.15.20.0.80.0.20.0.0.0.20.0.0.0. Hypertensive/large vessel disease 283 2604.5 171855.857.352.354.641.341.56.43.823.719.65.33.8 Unspecified with renal failure 266 2444.34.218 56.857.450.052.943.643.46.43.722.918.05.34.1 Renal artery stenosis * *0.10.214 57.166.785.777.814.311.10.011.142.955.60.0 Renal artery occlusion * *0.1 01722.220.088.980.00.020.011.10.022.220.011.10.0 Cystic/hereditary/congenital diseases 2,088 2,22933.538.310 68.167.475.274.818.018.56.86.651.1 3.22.8 Polycystic kidneys, adult type (dominant) 30 330.50.6141543.357.683.372.713.327.33.30.060.051.50.0 Polycystic, infantile (recessive) 142 1502.32.69156.344.776.178.016.916.77.05.353.539.37.011.3 Medullary cystic disease, inc. nephronophthisis 97 1061.61.8111336.150.084.584.94.17.511.37.569.170.81.00.0 Tuberous sclerosis * *0.1 171837.540.050.040.050.060.00.0 25.020.00.0 Hereditary nephritis, Alport's syndrome 152 1332.42.3161783.683.574.364.720.424.15.311.350.048.91.30.0 Cystinosis 62 491.00.8121351.659.290.391.89.78.20.0 77.475.50.0 Primary oxalosis 17 *0.30.28252.980.082.480.011.810.05.910.047.170.00.0 Congenital nephrotic syndrome 136 1312.22.32355.954.271.380.219.912.28.87.650.748.98.14.6 Drash syndrome, mesangial sclerosis 15 290.20.51060.058.680.082.80.017.220.00.026.734.513.36.9 Congenital ureterpelvic junction obstruction 31 430.50.7111380.686.077.460.516.139.56.50.051.648.80.02.3 Congenital uretrovesical junction obstruction 25 500.40.9131188.086.072.070.028.020.00.010.052.050.00.02.0 Other congenital obstructive uropathy 514 8.28.8111084.681.568.571.823.523.78.04.545.148.22.71.2 Renal hypoplasia, dysplasia, oligonephronia 698 69111.211.910962.362.476.975.515.916.97.27.550.052.23.42.9 Prune belly syndrome 82 801.31.47597.698.875.667.522.027.52.45.056.155.00.01.3 Other (congenital malformation syndromes) 79 2041.33.5141250.656.483.578.913.910.32.510.855.751.02.54.4 vol 2 Table 7.1 : Distribution of reported incident pediatric ESRD patients by primary diagnosis, 2003-2007 (period A) and 2008-2012 (period B) (aged 0-19 years) (cont’d)

6. Vol 2, ESRD, Ch 76 TransplantDied TotalIncidentAgeMaleWhiteAfrican AmOther Racefirst year Patients %Median%% % A B A B A B A B A B A B A B A B A B Neoplasms/tumors 161 1222.62.114 50.950.871.468.021.122.17.59.832.332.014.315.6 Renal tumor (malignant) 38 330.6 5544.739.463.266.728.927.37.96.17.918.226.315.2 Renal tumor (unspecified) * *0.10.01710.0100.050.00.025.0100.025.00.050.0100.00.0 Transplanted organ complication, unspecified 21 *0.30.0141647.650.071.450.023.850.04.80.028.650.019.00.0 Transplanted kidney complication 46 130.70.2151758.776.973.984.619.615.46.50.058.723.10.0 Transplanted liver complication * *0.1 171562.525.062.5 25.012.5 25.050.087.50.0 Transplanted heart complication 20 250.30.4141555.052.080.064.015.024.05.012.030.048.020.016.0 Bone marrow transplant complication 12 250.20.4121750.060.091.764.08.328.00.08.08.312.033.312.0 Miscellaneous conditions 406 3896.56.713 55.455.366.773.828.118.35.28.036.2 8.96.9 Sickle cell disease/anemia 14 *0.2 18 64.390.00.010.0100.090.00.0 14.310.021.40.0 Post partum renal failure * *0.1 171911.10.066.771.433.314.30.014.333.30.0 AIDS nephropathy 44 150.70.3161847.753.313.60.086.4100.00.0 13.620.0 Traumatic or surgical loss of kidney(s) 15 *0.2 81366.760.093.350.06.740.00.010.040.020.013.310.0 Hepatorenal syndrome * *0.1 111625.050.075.066.725.00.0 33.30.050.075.016.7 Tubular necrosis 114 1311.82.321151.860.378.979.414.014.57.06.115.820.69.610.7 Other renal disorders 205 2103.33.6131260.552.474.180.019.511.06.39.057.651.45.43.8 Etiology uncertain 600 4769.68.215 58.557.171.870.220.321.87.88.039.344.13.21.5 Missing 308 3904.96.7131462.059.213.014.93.97.783.177.496.490.51.32.3 Data Source: Special analyses, USRDS ESRD Database. Abbreviations: AIDS, acquired-immune deficiency syndrome; ESRD, end-stage renal disease; GN glomerulonephritis; IgA immunoglobulin A; IgM, immunoglobulin M; MPGN, membranoproliferative glomerulonephritis; SBE, sub-acute bacterial endocarditis. *Suppressed due to inadequate sample size..Zero values in this cell. vol 2 Table 7.1 : Distribution of reported incident pediatric ESRD patients by primary diagnosis, 2003-2007 (period A) and 2008-2012 (period B) (aged 0-19 years) (cont’d)

7. Vol 2, ESRD, Ch 77 Data Source: Reference tables A1, E9, M1, and special analyses, USRDS ESRD Database. The rate of ESRD per million among the U.S. population age 0-19 and the rate of transplantation in dialysis patients age 0-19 at the time of transplant, 1989–2012. Abbreviations: ESRD, end-stage renal disease. vol 2 Figure 7.2 Trends in pediatric transplantation (aged 0-19 years) (a) Incidence rate of ESRD and transplant rate in children

8. Vol 2, ESRD, Ch 78 Data Source: Reference tables E2, E3, and special analyses, USRDS ESRD Database. The waiting list count provides the number of pediatric candidates aged 0-19 years on the Organ Procurement and Transplantation Network kidney transplant waiting list on December 31 of each year for first and subsequent kidney alone or kidney plus pancreas transplantation. Candidates listed at more than one center on December 31 are counted only once. There are no data available for median waiting list time for patients with prior transplants listed after 2008. Abbreviations: Tx, transplant. vol 2 Figure 7.2 Trends in pediatric transplantation (aged 0-19 years) (b) Waiting list count

9. Vol 2, ESRD, Ch 79 Data Source: Reference tables E8, E8(2), E8(3), and special analyses, USRDS ESRD Database. This figure represents kidney alone and kidney plus pancreas transplant counts for all pediatric candidates. vol 2 Figure 7.2 Trends in pediatric transplantation (aged 0-19 years) (c) Total transplants

10. Vol 2, ESRD, Ch 710 Data Source: Reference table D9. This is the cumulative count of functioning pediatric kidney and kidney-pancreas transplants. vol 2 Figure 7.2 Trends in pediatric transplantation (aged 0-19 years) (d) Total functioning transplants

11. Vol 2, ESRD, Ch 711 Data Source: Reference Table E9, and special analyses, USRDS ESRD Database. Includes transplant year between 1991–2012. vol 2 Figure 7.3 Live and deceased donor transplants in pediatric patients (aged 0-19 years) (a) Transplant rate in pediatric dialysis patients by age

12. Vol 2, ESRD, Ch 712 Data Source: Reference Table E9, and special analyses, USRDS ESRD Database. Includes transplant year between 1991–2012. vol 2 Figure 7.3 Live and deceased donor transplants in pediatric patients (aged 0-19 years) (b) Transplant rate in pediatric dialysis patients by sex

13. Vol 2, ESRD, Ch 713 Data Source: Reference Table E9, and special analyses, USRDS ESRD Database. Includes transplant year between 1991–2012. vol 2 Figure 7.3 Live and deceased donor transplants in pediatric patients (aged 0-19 years) (c) Transplant rate in pediatric dialysis patients by race

14. Vol 2, ESRD, Ch 714 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.4 Hospitalization rates in pediatric patients (aged 0-19 years) (a) One-year adjusted all-cause hospitalization rates in pediatric patients by age

15. Vol 2, ESRD, Ch 715 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.4 Hospitalization rates in pediatric patients (aged 0-19 years) (b) One-year adjusted all-cause hospitalization rates in pediatric patients by modality

16. Vol 2, ESRD, Ch 716 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.5 Cardiovascular hospitalization rates in children (aged 0-19 years) (a) One-year adjusted cardiovascular hospitalization rates in pediatric patients by age

17. Vol 2, ESRD, Ch 717 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.5 Cardiovascular hospitalization rates in children (aged 0-19 years) (b) One-year adjusted cardiovascular hospitalization rates in pediatric patients by modality

18. Vol 2, ESRD, Ch 718 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.6 Infection hospitalization rates in children (aged 0-19 years) (a) One-year adjusted hospitalization rates for infection in pediatric patients by age

19. Vol 2, ESRD, Ch 719 Data Source: Special analyses, USRDS ESRD Database. Includes incident ESRD patients in the years 2002-2011, surviving the first 90 days after ESRD initiation and followed from day 90. Adjusted for sex, race, primary diagnosis and Hispanic ethnicity. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.6 Infection hospitalization rates in children (aged 0-19 years) (b) One-year adjusted hospitalization rates for infection in pediatric patients by modality

20. Vol 2, ESRD, Ch 720 Data Source: Reference tables F2, F14, I26. Probabilities for all-cause graft failure and return to dialysis or retransplant are adjusted for age, sex, race, primary diagnosis, and first versus subsequent transplant. All-cause graft failure includes retransplant, return to dialysis, and death. The death outcome is not censored at graft failure, and includes deaths that occur after retransplant or return to dialysis. Probabilities of death are adjusted for age, sex, race, and primary diagnosis. The reference population for all-cause graft failure and return to dialysis or repeat transplantation is all pediatric patients receiving a kidney alone transplant in 2011. The reference population for death is incident pediatric ESRD patients in 2011. vol 2 Figure 7.7 One year transplant outcomes by donor type (aged 0-19 years) (a) Outcomes: deceased donor transplants in pediatric patients, adjusted

21. Vol 2, ESRD, Ch 721 Data Source: Reference tables F8, F20, I32. Probabilities for all-cause graft failure and return to dialysis or retransplant are adjusted for age, sex, race, primary diagnosis, and first versus subsequent transplant. All-cause graft failure includes retransplant, return to dialysis, and death. The death outcome is not censored at graft failure, and includes deaths that occur after retransplant or return to dialysis. Probabilities of death are adjusted for age, sex, race, and primary diagnosis. The reference population for all-cause graft failure and return to dialysis or repeat transplantation is all pediatric patients receiving a kidney alone transplant in 2011. The reference population for death is incident pediatric ESRD patients in 2011. vol 2 Figure 7.7 One year transplant outcomes by donor type (aged 0-19 years) (b) Outcomes: live donor transplants in pediatric patients, adjusted

22. Vol 2, ESRD, Ch 722 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.8 Mortality rates in children with ESRD (aged 0-19 years) (a) One-year adjusted all-cause mortality rates in pediatric patients by age

23. Vol 2, ESRD, Ch 723 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.8 Mortality rates in children with ESRD (aged 0-19 years) (b) One-year adjusted all-cause mortality rates in pediatric patients by modality

24. Vol 2, ESRD, Ch 724 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.9 Cardiovascular mortality in children with ESRD (aged 0-19 years) (a) One-year adjusted all-cause cardiovascular mortality rates in pediatric patients by age

25. Vol 2, ESRD, Ch 725 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.9 Cardiovascular mortality in children with ESRD (aged 0-19 years) (b) One-year adjusted all-cause cardiovascular mortality rates in pediatric patients by modality

26. Vol 2, ESRD, Ch 726 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.10 Infection-related mortality in children with ESRD (aged 0-19 years) (a) One-year adjusted rates of mortality due to infection in pediatric patients by age

27. Vol 2, ESRD, Ch 727 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.10 Infection-related mortality in children with ESRD (aged 0-19 years) (b) One-year adjusted rates of mortality due to infection in pediatric patients by modality

28. Vol 2, ESRD, Ch 728 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.11 Pediatric ESRD patient survival by age and modality (aged 0-19 years) (a) Adjusted 5 year survival in pediatric patients from day 1 by age, years 2003-2007

29. Vol 2, ESRD, Ch 729 Data Source: Special analyses, USRDS ESRD Database. Incident dialysis and transplant patients defined at the onset of dialysis or the day of transplant without the 60-day rule; followed to December 31, 2012. Adjusted for age, sex, race, Hispanic ethnicity, and primary diagnosis. Ref: incident ESRD patients age 0-19, 2010-2011. Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; Tx, transplant. vol 2 Figure 7.11 Pediatric ESRD patient survival by age and modality (aged 0-19 years) (b) Adjusted 5 year survival in pediatric patients from day 1 by modality, years 2003-2007