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Clinical characteristics and outcomes of children with stage 3-5 chronic kidney disease

Tran Thi Mong Hiep1, Khalid Ismaili, Frederic Collart

  • 1Department of Pediatrics, Nhi Dong 2 Hospital-Grall, University Pham Ngoc Thach, 86/2 Thanh Thai Quan 10, Ho Chi Minh City, Vietnam. tranmonghiep@yahoo.fr

Pediatric Nephrology (Berlin, Germany)
|February 12, 2010
PubMed

Insights

Belgian children diagnosed with chronic kidney disease (CKD) primarily have congenital anomalies of the kidney and urinary tract (CAKUTs). Early detection and management are crucial as progression to end-stage renal failure (ESRF) is significant.

Area of Science:

  • Pediatric Nephrology
  • Clinical Epidemiology
  • Renal Medicine

Background:

  • Chronic kidney disease (CKD) in children presents unique challenges in diagnosis and management.
  • Understanding the epidemiology and clinical characteristics of pediatric CKD is essential for improving patient outcomes.

Purpose of the Study:

  • To describe the clinical features and outcomes of Belgian children diagnosed with chronic kidney disease (CKD).
  • To determine the incidence of CKD and renal replacement therapy (RRT) in a pediatric population.
  • To identify the primary causes and progression rates of pediatric CKD.

Main Methods:

  • Prospective follow-up of 143 new pediatric patients (<20 years) with CKD (glomerular filtration rate <60 ml/min/1.73 m(2)) between 2001 and 2005.
  • Analysis of patient demographics, CKD etiology, stage at diagnosis, progression to end-stage renal failure (ESRF), and causes of mortality.
  • Calculation of incidence rates per million child population (pmcp).

Main Results:

  • The incidence of diagnosed CKD was 11.9 pmcp, with RRT incidence at 6.2 pmcp.
  • Congenital anomalies of the kidney and urinary tract (CAKUTs) were the leading cause (59%), followed by hereditary (median age 2 years) and glomerular diseases (median age 10 years).
  • Conservative treatment led to ESRF in 38% of patients after 5 years; CKD stage 4 progressed eightfold faster than stage 3. Hereditary diseases showed faster progression than CAKUTs. Preemptive transplantation occurred in 22% of cases. Infections and cardiovascular diseases were primary causes of death.

Conclusions:

  • CAKUTs are the predominant cause of pediatric CKD in Belgium, necessitating early intervention.
  • Progression to ESRF is a significant concern, particularly in later CKD stages and with specific etiologies like hereditary diseases.
  • A substantial proportion of children require RRT, highlighting the need for improved preventative strategies and timely transplantation.

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