Pediatric Nephrology

Pediatric Nephrology

2018 - 2022

The Department of Pediatric Nephrology is a part of a SCOPE collaborative, which is a nationwide initiative to decrease infections in peritoneal dialysis and hemodialysis patients. This collaborative has standardized line care for patients and decreased infection rates among patients.
CLABSI rates are presented per 1000 CVC (central vascular catheter) days, and per 100 patients/month. CLABSI rates are not expressed in terms of inpatient days, as these patients return home between treatments. Line care is performed both inside and outside of the hospital.
Children's Hospital Association. (n.d.). SCOPE dialysis collaborative. https://www.childrenshospitals.org/Programs-and-Services/Quality-Improvement-and-Measurement/Collaboratives/SCOPE
Cleveland Clinic's target for this metric is based on national data provided by the CDC.

CLABSI Rates per 1000 CVC Days

2018 - 2022

Cleveland Clinic's target for this metric is based on one study that evaluated CLABSI rates in children on dialysis, which found an infection rate of 1.9 per 1000 catheter-days.

Hayes, W. N., Watson, A. R., Callaghan, N., Wright, E., Stefanidis, C. J., & European Pediatric Dialysis Working Group. (2012). Vascular access: choice and complications in European paediatric haemodialysis units. Pediatric Nephrology, 27(6), 999-1004.

CVC= central vascular catheter

Hemoglobin Maintained Less Than 10 g/dL

2018 - 2022

Cleveland Clinic Children’s has improved anemia outcomes through more diligent monitoring to help patients maintain hemoglobin levels between 10 g/dL and 12 g/dL, which is important in maintaining dialysis patients’ health and quality of life. Our anemia rates are well below the national average.

Peritonitis Rates

2018 - 2022

Acute peritonitis is considered the most dreaded complication of peritoneal dialysis, often resulting in significant morbidity and mortality. Our target peritonitis rate is based on the national average reported by the SCOPE collaborative (see above).

Pediatric Nephrology_% Kt/V > 1.8 PD

2018 - 2022

Dialysis adequacy is measured in two ways: urea reduction ratio and Kt/V. Cleveland Clinic's target for this metric is based on national averages provided by CMS. Good "dialysis adequacy" as measured by the Kt/V number suggest that the dialysis treatments are working well to get rid of waste products. The current KDOQI international guidelines state that Kt/V should remain above 1.7 in most patients receiving chronic peritoneal dialysis.