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Chronic kidney disease in children: A report from a tertiary care center over 11 years
Alaleh Gheissari1, Saeedeh Hemmatzadeh2, Alireza Merrikhi1
1Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran. ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Pediatric chronic kidney disease (CKD) is common, with glomerular diseases being the leading cause. This study highlights a high incidence of advanced CKD in children, emphasizing the need for early detection and intervention.
Area of Science:
- Pediatric Nephrology
- Epidemiology
- Public Health
Background:
- Chronic kidney disease (CKD) poses a significant health burden in children.
- Epidemiologic studies are crucial due to racial, ethnic, and etiological variations in pediatric CKD.
- Existing data on CKD incidence often comes from hospitalized pediatric populations.
Purpose of the Study:
- To determine the incidence and causes of chronic renal failure (CRF) in children.
- To analyze pediatric CKD cases within a tertiary care center in Isfahan, Iran.
Main Methods:
- Retrospective analysis of medical records for children (<19 years) hospitalized with CKD.
- Data collected from November 2001 to December 2011 at St Alzahra hospital.
- Patients categorized by Glomerular Filtration Rate (GFR) using KDOQI guidelines.
Main Results:
- Glomerular diseases (34%) and reflux nephropathy (16.7%) were the primary etiologies of pediatric CKD.
- Most patients (74.8%) presented with advanced CKD (GFR < 15 ml/min/m²).
- High rates of hypertension (55%), anemia (85%), and kidney replacement therapy (72.3%) were observed. Annual incidence was 16.8 per million children.
Conclusions:
- Glomerular diseases are the predominant cause of CKD in the studied pediatric population.
- The annual incidence of pediatric CKD in this region is notably high.
- Younger age was identified as an independent predictor of mortality in pediatric CKD patients.
Background:
Chronic kidney disease (CKD) is an overwhelming illness in children. Considering the importance of CKD in pediatric age group, in addition to the racial and ethnic differences in prevalence and etiology of CKD, epidemiologic studies are recommended. The majority of the results regarding the incidence of CKD have been achieved from studies on hospitalized children.
Objectives:
This study evaluates the incidence and etiology of chronic renal failure (CRF) in children in a tertiary care center in Isfahan, the second large province of Iran.
Patients And Methods:
A retrospective analysis of medical record data of children less than 19 years old, hospitalized for CKD at St Alzahra hospital, Isfahan, Iran, during the period of November 2001 until December 2011 was made. A total of 268 eligible cases were recruited. Patients were categorized into 5 groups according to glomerular filtration rate (GFR) and KDOQI guideline.
Results:
Out of 268 patients, 144 patients were male (54%). The mean and median of age was 11.01± 0.39(SD) years and 12.5 years, respectively. Approximately 55% of patients had either systolic and/or diastolic hypertension. The most frequent etiology of CKD was glomerular diseases (34%) followed by reflux nephropathy (16.7%). Most patients (74.8%) had GFR less than 15 ml/min/m², when diagnosed. Anemia was the most prevalent laboratory abnormality (85%). Small-size kidneys were seen in 65.8% of patients. Kidney replacement therapy (either hemo- or peritoneal dialysis) was applied for 72.3% of the patients. The transplantation rate average was 7.2 per million children population. The annual incidences of CKD (mostly advanced stages) were 5.52 per million population (PMP) and 16.8 per million children population, respectively. The all cause of mortality rate was 18.4%. Younger age was the only independent predictor of mortality (p=0.005).
Conclusions:
We concluded that glomerular diseases are the leading cause of CKD in our patients. In addition, the annual incidence of CKD is considerably high.
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