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What do we know about chronic renal failure in young adults? I. Primary renal disease

Guy H Neild1

  • 1University College London Centre for Nephrology, London NW3 2QG, UK. g.neild@ucl.ac.uk

Pediatric Nephrology (Berlin, Germany)
|February 5, 2009
PubMed

Insights

Congenital abnormalities of the kidney and urinary tract (CAKUT) are a major cause of pediatric end-stage renal failure. This study suggests CAKUT may be underdiagnosed in young adults, contributing to unspecified renal disease diagnoses.

Area of Science:

  • Nephrology
  • Paediatric Nephrology
  • Epidemiology

Background:

  • Congenital abnormalities of the kidney and urinary tract (CAKUT) account for a significant portion of end-stage renal failure in children.
  • Limited data exists on the primary causes of end-stage renal disease in adults under 30.
  • Registries show a high percentage of unspecified diagnoses in young adults with renal failure.

Purpose of the Study:

  • To investigate the prevalence of CAKUT as a cause of end-stage renal disease in young adults.
  • To compare the diagnostic patterns of renal disease in pediatric versus adult populations.
  • To determine if CAKUT is underdiagnosed in young adults.

Main Methods:

  • Analysis of data from the UK renal registry (2000-2006).
  • Review of the United States Renal Data System (USRDS) database (2005).
  • Comparison of diagnostic categories for end-stage renal disease across different age groups.

Main Results:

  • Adult registries report 20-27% of cases with 'no specific diagnosis', rising to 28-36% with unspecified groups.
  • CAKUT prevalence decreases significantly from 31% (ages 0-19) to 5% (ages 20-30) in USRDS data.
  • UK data shows a decrease in CAKUT to 26% for ages 18-21, coinciding with an increase in unspecified diagnoses.

Conclusions:

  • A substantial proportion of young adults with end-stage renal disease have unspecified primary diagnoses.
  • Nephrologists may underdiagnose CAKUT in young adult patients.
  • Underdiagnosis of CAKUT could explain a significant portion of unspecified renal disease in this demographic.

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