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[Epidemiology of chronic kidney disease in Spanish pediatric population. REPIR II Project]
R Areses Trapote1, M J Sanahuja Ibáñez, M Navarro
1Sección de Nefrología Pediátrica, Hospital Donostia, San Sebastián, Guipúzcoa.
Insights
The first Spanish registry of pediatric Chronic Kidney Disease (CKD) found structural anomalies as the main cause. Children under two years old had a higher probability of short stature, highlighting the need for early intervention in pediatric CKD.
Area of Science:
- Pediatric Nephrology
- Epidemiology
- Chronic Kidney Disease (CKD)
Context:
- A national registry, REPIR II, was established in Spain in 2007 to track pediatric Chronic Kidney Disease (CKD).
- The registry collects data from 46 centers across Spain, adhering to K/DOQI guidelines for patient classification and comorbidity assessment.
- This study analyzes data from children aged 18 or younger with CKD stages 2-5, pre-dialysis.
Purpose:
- To determine the incidence, prevalence, demography, etiology, and clinical/metabolic status of pediatric CKD in Spain.
- To provide a comprehensive epidemiological overview of CKD in the pediatric population.
- To establish a baseline for future research and clinical practice improvements in pediatric nephrology.
Summary:
- In 2008, the registry identified 605 pediatric CKD patients, with an incidence of 8.66 pmpp and prevalence of 71.06 pmpp.
- Structural anomalies were the leading cause (59%), with a low incidence of glomerular diseases (3%). Males (66%) and Caucasians (88%) predominated.
- Anemia affected 30%, hypertension 19%, and only 17% met K/DOQI calcium-phosphorus guidelines. Short stature was noted in 25%, particularly in children under two years old (OR=1.40). Malnutrition affected 7%.
Impact:
- This study provides the first prospective analysis of pediatric CKD in Spain, establishing crucial epidemiological data.
- Findings highlight the significant impact of CKD on growth and metabolic health in children.
- The provisional data underscores the need for continued monitoring and potential adjustments in clinical management strategies for pediatric CKD.
Objective:
A national registry of children with Chronic Kidney Disease (CKD) was started in 2007. We analize it to know the incidence, prevalence, demography, etiology, clinical and metabolic state of the children with CKD, in stages 2-5 pre-dialysis, and complying with the K/DOQI guidelines.
Material And Methods:
In the REPIR II 46 centers distributed throughout the Spanish geography are involved. To classify and evaluate comorbidity of the disease, the Clinical Practice Guidelines K/DOQI criteria are used. Each center provides an annual developmental data of each patient which is recorded in a On-line database.
Inclusion Criteria:
patients with CKD who are between stage 2 and 5 in predialysis and which are 18 years old or less.
Results:
In 2008 there were 605 patients with CKD, the incidence was 8.66 per million of pediatric population (pmpp) and the prevalence was 71.06 pmpp. Structural anomalies was the primary cause of CKD (59% of the cases). The percentage of glomerular diseases was very low (3%). There was a clear predominance of males (66%) and Caucasian race (88%). Mean GFR was 52 ± 2 ml/min/1.73 m(2) with 82% of them in stage 2 and 3. The prevalence of anaemia was 30%. Only 19% of our patients had hypertension and only 17% of them fulfilled the 4 recommendations for calcium-phosphorus metabolism of K/DOQI Guidelines. Mean height Z-Score was -1.03 ± 2. There were 136 patients (25%) who had a mean height Z-Score of size < or = -1.88. In a multivariate logistic regression analysis only a meaningful relationship between age and height was identified. All the children under 2 years old had a 40% higher probability of having a short height (OR = 1.40; P < 0.01). The percentage of malnutrition (BMI Z-Score < or = 1.88) was 7%, mostly in the 0-2 years old group.
Conclusions:
We report the first study that performs a prospective analysis of incidence, prevalence, etiology and comorbidity of CKD in the pediatric population of the Spanish State. Given the short life of this record the data presented is provisional and may suffer meaningful changes in coming years.
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