ABSTRACT
Background: Data on comorbidities in children on kidney replacement therapy (KRT) are scarce. Considering their high relevance for prognosis and treatment, this study aims to analyse the prevalence and implications of comorbidities in European children on KRT. Methods: We included data from patients <20 years of age when commencing KRT from 2007 to 2017 from 22 European countries within the European Society of Paediatric Nephrology/European Renal Association Registry. Differences between patients with and without comorbidities in access to kidney transplantation (KT) and patient and graft survival were estimated using Cox regression. Results: Comorbidities were present in 33% of the 4127 children commencing KRT and the prevalence has steadily increased by 5% annually since 2007. Comorbidities were most frequent in high-income countries (43% versus 24% in low-income countries and 33% in middle-income countries). Patients with comorbidities had a lower access to transplantation {adjusted hazard ratio [aHR] 0.67 [95% confidence interval (CI) 0.61-0.74]} and a higher risk of death [aHR 1.79 (95% CI 1.38-2.32)]. The increased mortality was only seen in dialysis patients [aHR 1.60 (95% CI 1.21-2.13)], and not after KT. For both outcomes, the impact of comorbidities was stronger in low-income countries. Graft survival was not affected by the presence of comorbidities [aHR for 5-year graft failure 1.18 (95% CI 0.84-1.65)]. Conclusions: Comorbidities have become more frequent in children on KRT and reduce their access to transplantation and survival, especially when remaining on dialysis. KT should be considered as an option in all paediatric KRT patients and efforts should be made to identify modifiable barriers to KT for children with comorbidities.
ABSTRACT
Background: The usage of the internet amid university students and has increased significantly. Internet dependence between university students rises the hazard of adverse mental, somatic, economic concerns. Objective: The objective of our study is to determine the prevalence and aspects related to internet dependence amid university students in the University of Medicine in Tirana, Albania. Methods: This cross-sectional study was held in June-August 2022 at University of Medicine in Tirana, Albania. By using Internet Addiction Test (IAT) we collected data on respondents' social-demographic features, internet use rehearsals, observed mental status and interactive bond of participants. Results: From 405 students who delivered their whole reply, we found that the prevalence of Internet Dependence is 109(27.65%).Regarding the gender the majority of the participants were females 275 (67.91%). Prior to the field of study the nursing students involved the larger part of the respondents 177 (43.7%). 234 (57.77%) of the students reported to have a middle economic status. Conclusion: Almost twenty eight percent of medical university students in Albania depend on the internet. Internet dependence is correlated with applying the internet at the university, using more time on the internet per day, and spending the internet for social media. More surveys are required to regulate the load of psychological issues related to internet dependence in high-risk populations.
