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Purpose: To evaluate the characteristics and frequency of remission in pediatric patients with Graves' disease (GD) treated with antithyroid drug (ATD) and to identify factors that may be associated with relapse. Methods: Medical records of patients younger than 19 years who presented to the Department of Pediatrics of Queen Elizabeth Hospital Hong Kong with newly diagnosed GD from 1st January 2007 to 31st December 2017 were retrospectively reviewed. Remission was defined as euthyroidism for 12 months or more after discontinuation of ATD treatment and no relapses during the follow-up period. Patients who successfully achieved remission were compared to those who suffered relapse. Factors that may predict occurrence of relapse after ATD treatments were studied, and their odds ratios (ORs) were calculated. Results: A total of 101 patients was included in this study. Eighty-one patients completed one course of ATD. Eighteen patients (17.8%) successfully achieved remission, and 58 patients (57.4%) experienced relapse after discontinuation of ATD. The remission group received a significantly longer course of ATD therapy than the relapse group (median, 28 months; interquartile range [IQR], 18-48 months in remission group vs. median, 21 months; IQR, 17-26; P=0.024). The OR for relapse was 0.971 (95% confidence interval [CI], 0.946-0.997) in univariate analysis and remained significant after adjustments in the multivariate regression model (OR, 0.961; 95% CI, 0.933-0.989; P=0.008). Conclusion: The remission rate in pediatric patients with GD treated with ATD was low. A longer ATD course was associated with a greater chance of remission in this population. [ABSTRACT FROM AUTHOR]

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. SUMMARY AT A GLANCE: The incidence of kidney failure per million age‐related population in Hong Kong has more than doubled from 2001–2005 to 2016–2020, with a considerable waiting time to kidney transplantation. Mortality risk is comparable to that observed in other developed countries and is highest among those on dialysis. Efforts should be made to facilitate early transition to paediatric kidney transplantation. [ABSTRACT FROM AUTHOR]