Mapping the future of childhood kidney failure

Survival rates following a paediatric kidney transplant have improved over the last five decades. 

However, children and young adults with kidney failure statistically still don’t live as long as their healthy peers. 

Dr Anna Francis from UQ’s Children’s Health Queensland Clinical Unit is working towards changing this for the 3000 young Australians with kidney failure. 

A paediatric nephologist and clinician researcher, Dr Francis’ work focuses on the impact of childhood kidney disease, and how to enhance outcomes in paediatric kidney transplantation. 

“Children and adolescents receiving kidney transplants today have much better survival outcomes than those transplanted in earlier decades,” Dr Francis said. 

“My research has found 5-year survival increased from 85 per cent for people who received transplants between 1970 and 1985, to 99 per cent between 2005 and 2015. 

“This improvement is largely due to reductions in cardiovascular and infection-related deaths.

“However, there is still a discrepancy when a transplant fails resulting in a higher increase in mortality risk.

“This highlights the need for ongoing monitoring, medication adherence and access to specialist care.”

The results come from research Dr Francis conducted during her PhD, using data from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA). 

The study included 1,810 children and adolescents who received their first kidney transplant between 1970 and 2015 and followed their progress for around 13 years.

“Kidney transplantation has become a highly successful long-term treatment for young people with end-stage kidney disease, allowing more children to survive into adulthood and experience better quality of life,” Dr Francis said. 

“However, we still need more research to map out the life course impacts of kidney failure during childhood and young adulthood.”

Now, with new funding from the National Health and Medical Research Council, Dr Francis will expand her research to answer this question.  

“This will allow us to understand the risks and hopefully identify factors we can target to improve long term outcomes,” Dr Francis said. 

“The research will link the national dialysis and transplant registry to state and federal health, maternity and educational datasets.

“Working with colleagues at the transplant registry, ANZDATA and The University of Sydney, we hope this research will continue to improve outcomes for young people with kidney failure.”