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Chronic renal failure in children.

Pankaj Hari1, Ish Kumar Singla, Mukta Mantan

  • 1Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. pankajhari@hotmail.com

Indian Pediatrics
|December 9, 2003
PubMed
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The most common causes of chronic renal failure (CRF) in children were obstructive and reflux nephropathy. Many children presented late with severe disease, malnutrition, and stunted growth, often managed conservatively due to financial constraints.

Area of Science:

  • Pediatric Nephrology
  • Renal Medicine
  • Public Health

Background:

  • Chronic renal failure (CRF) in children presents a significant health challenge.
  • Understanding the specific etiologies and patient demographics is crucial for effective management.

Purpose of the Study:

  • To identify the primary causes of chronic renal failure (CRF) in pediatric patients at a tertiary care center.
  • To analyze the clinical presentation and outcomes of children with CRF.

Main Methods:

  • Retrospective review of 305 children diagnosed with chronic renal failure (CRF) over a 7-year period.
  • CRF defined as glomerular filtration rate (GFR) < 50 mL/1.73 m²/min for > 3 months.
  • Data collected on age, GFR, blood urea, creatinine, hemoglobin, anthropometrics, etiology, and management.

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Main Results:

  • Obstructive uropathy (97 children) and chronic glomerulonephritis (84 children) were the leading causes of CRF.
  • Patients presented with a mean age of 8 years, significantly low GFR (median 18.5 mL/min/1.73 m²), anemia, malnutrition, and stunted growth.
  • Late presentation was common, with 25.3% already in end-stage renal disease.

Conclusions:

  • Obstructive and reflux nephropathy are the most frequent causes of pediatric CRF.
  • Late presentation, severe disease, malnutrition, and stunting are prevalent issues.
  • Financial constraints significantly impacted management, leading to conservative care for many patients.