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Published on: June 23, 2015
Demography of renal disease in childhood
1Royal Manchester Children's Hospital, Central Manchester and Manchester Children's University Hospitals NHS Trust, Pendlebury, Manchester, UK. malcolm.lewis@cmmc.nhs.uk
Insights
Childhood renal failure is primarily caused by renal dysplasia. Early diagnosis impacts progression, but antenatal screening limitations affect detection rates in pediatric kidney disease.
Area of Science:
- Pediatric Nephrology
- Renal Disease Epidemiology
Background:
- Established renal failure (ERF) in children presents unique demographic challenges.
- Understanding the causes and progression of pediatric chronic kidney disease (CKD) is crucial for timely intervention.
Purpose of the Study:
- To analyze the demography of pediatric ERF using UK Renal Registry data.
- To investigate the role of antenatal diagnosis in the progression of childhood kidney disease.
Main Methods:
- Analysis of UK Renal Registry data for patients with established renal failure (ERF).
- Review of chronic kidney disease (CKD) population studies focusing on pediatric demographics.
Main Results:
- Renal dysplasia and related conditions are the leading causes of pediatric ERF.
- Congenital obstructive uropathy is a significant factor, particularly in early childhood, with a male predominance.
- Antenatal diagnosis rates are suboptimal despite routine ultrasounds, impacting disease progression timelines.
Conclusions:
- Renal dysplasia is the primary driver of childhood renal failure.
- Limitations in antenatal ultrasound screening contribute to discrepancies in diagnosis and postnatal presentation.
- Optimizing antenatal detection is key to improving outcomes for children with kidney disease.
Abstract:
The demography of renal failure in childhood is examined through an analysis of the UK Renal Registry data on patients in established renal failure (ERF) and studies of chronic kidney disease populations. The predominant cause is renal dysplasia and related conditions. Congenital obstructive uropathy is the third largest group overall and the second in early childhood. Males predominate in both these groups. Antenatal diagnoses are frequently not made despite routine scanning. Those children, who present to nephrology after the age of 3 months without an antenatal diagnosis, progress to ERF later than those diagnosed antenatally. Discrepancies exist between the demography of antenatal diagnoses and those seen postnatally. This is likely to represent the limitations of antenatal ultrasound as a diagnostic screening tool.
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