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Epidemiology of chronic kidney disease in children

Jérôme Harambat1, Karlijn J van Stralen, Jon Jin Kim

  • 1ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Pediatric Nephrology (Berlin, Germany)
|June 30, 2011
PubMed

Insights

Pediatric chronic kidney disease (CKD) care has improved, but data on early stages are limited. Congenital disorders are a major cause, and while survival has increased, children with end-stage renal disease (ESRD) still face significant risks.

Area of Science:

  • Pediatric Nephrology
  • Renal Epidemiology
  • Chronic Kidney Disease (CKD) Research

Background:

  • Significant advancements in pediatric chronic kidney disease (CKD) care over the last 30 years.
  • Limited epidemiological data available for earlier stages of pediatric CKD, with most data derived from end-stage renal disease (ESRD) registries.
  • Global median incidence of renal replacement therapy (RRT) in children (0-19 years) was 9 per million in 2008, with prevalence ranging from 18-100 per million.

Purpose of the Study:

  • To summarize the current state of pediatric CKD, focusing on epidemiology, causes, and outcomes.
  • To highlight the differences in CKD progression between congenital and acquired causes.
  • To underscore the remaining challenges in improving survival rates for children with ESRD.

Main Methods:

  • Review of epidemiological data from ESRD registries.
  • Analysis of global incidence and prevalence of RRT in pediatric populations.
  • Comparison of CKD progression based on etiology (congenital vs. acquired).

Main Results:

  • Congenital disorders (e.g., congenital anomalies of the kidney and urinary tract - CAKUT) account for approximately two-thirds of pediatric CKD cases in developed countries; acquired causes are more prevalent in developing nations.
  • Children with congenital disorders exhibit slower CKD progression compared to those with glomerulonephritis.
  • While survival rates for pediatric ESRD have improved, they remain substantially lower than in the general population, with cardiovascular disease and infection being leading causes of mortality.

Conclusions:

  • Congenital anomalies of the kidney and urinary tract (CAKUT) are a primary driver of pediatric CKD, particularly in earlier stages.
  • Despite improved survival, children with ESRD face a significantly higher mortality risk, primarily due to cardiovascular issues and infections.
  • Further research and improved management strategies are crucial for enhancing long-term outcomes in pediatric CKD patients.

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