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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Epidemiology of chronic kidney disease in children in Serbia
Amira Peco-Antic1, Radovan Bogdanovic, Dusan Paripovic
1Faculty of Medicine, University of Belgrade, Belgrade, Serbia. amira@udk.bg.ac.rs
Insights
This study reports on childhood chronic kidney disease (CKD) in Serbia, finding its epidemiology similar to developed European nations. Understanding early-stage CKD is crucial for effective treatment and resource planning.
Area of Science:
- Pediatric Nephrology
- Epidemiology
- Public Health
Background:
- Limited epidemiological data exists for childhood chronic kidney disease (CKD), especially non-terminal stages.
- Current data often relies on renal replacement therapy (RRT) figures, potentially underestimating earlier CKD prevalence.
- This study presents epidemiological data for pediatric CKD in Serbia over a decade.
Purpose of the Study:
- To report basic epidemiological data on childhood CKD in Serbia.
- To analyze incidence, prevalence, etiology, treatment, and outcomes of pediatric CKD.
- To provide insights for improved management and resource allocation in pediatric nephrology.
Main Methods:
- Data collected from Serbian pediatric centers (2000-2009) for children aged 0-18 years with CKD Stages 2-5.
- Included incidence, prevalence, etiology, treatment modalities, and outcomes.
- Analysis based on reported index cases.
Main Results:
- 336 children registered; median age 9.0 years; median follow-up 4.0 years.
- Median GFR at registration was 39.6 mL/min/1.73m(2).
- Incidence of CKD 2-5 was 14.3 p.m.a.r.p.; prevalence was 96.1 p.m.a.r.p. Congenital anomalies and hereditary nephropathies were main causes. Kidney survival was poorest in glomerular diseases and advanced CKD. Hemodialysis was the most common initial RRT. Mortality rate was 4.5%.
Conclusions:
- Pediatric CKD epidemiology in Serbia mirrors that of developed European countries.
- Understanding early CKD stages is vital for renoprotective therapy and RRT planning, especially in resource-limited settings.
Background:
The epidemiological information from well-defined populations regarding childhood chronic kidney disease (CKD), particularly those concerning non-terminal stages, are scanty. The epidemiology of CKD in children is often based on renal replacement therapy (RRT) data, which means that a considerable number of children in earlier stages of CKD are missed as they will reach end-stage renal disease (ESRD) in adulthood. Here, we report the basic epidemiological data on childhood CKD in Serbia, gathered over the 10-year period of activity of the Serbian Pediatric Registry of Chronic Kidney Disease.
Methods:
Since 2000-09, data on incidence, prevalence, aetiology, treatment modalities and outcome of children aged 0-18 years, with CKD Stages 2-4 and CKD Stage 5, were collected by reporting index cases from paediatric centres.
Results:
Three hundred and thirty-six children were registered (211 boys, 125 girls, male/female ratio 1.7). The median age at registration was 9.0 years [interquartile range (IQR) 3-13]. Median follow-up was 4.0 years (IQR, 1-9). The median glomerular filtration rate (GFR) at the time of the registration was 39.6 mL/min/1.73m(2) (IQR, 13.8-65.4). Median annual incidence of CKD 2-5 stages was 14.3 per million age-related population (p.m.a.r.p.), while those of CKD 2-4 or CKD 5 were 9.1 and 5.7 p.m.a.r.p., respectively. The median prevalence of CKD 2-5 was 96.1 p.m.a.r.p., 52.8 p.m.a.r.p. in CKD 2-4 and 62.2 p.m.a.r.p. in CKD 5. The main causes of CKD were congenital anomalies of kidney and urinary tract and hereditary nephropathies. Kidney survival was the worst in children with glomerular diseases and in those with advanced CKD. Haemodialysis was the most common first modality of RRT. Mortality rate was 4.5%, mainly due to cardiovascular and infectious complications.
Conclusions:
Epidemiology of paediatric CKD in Serbia is similar to that reported from developed European countries. The knowledge of the epidemiology of earlier stages of CKD is essential for both institution of renoprotective therapy and planning of RRT, a fact of paramount importance in countries with limited resources.
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