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[Chronic renal insufficiency in 22 children: diagnosis and evolution]
I Riaño Galán1, C Rey Galán, A Del Molino Anta
1Departamento de Pediatría, Hospital Materno-Infantil de la Seguridad Social, Nuestra Señora de Covadonga, Facultad de Medicina, Oviedo.
Insights
This study in children with chronic renal failure found recurrent urinary tract infections and obstructive uropathies were common. Growth delay at diagnosis did not significantly worsen over time.
Area of Science:
- Pediatric Nephrology
- Renal Physiology
- Clinical Pediatrics
Context:
- Chronic renal failure (CRF) affects children, impacting growth and kidney function.
- Understanding the clinical course of pediatric CRF is crucial for management.
- Limited data exists on the evolution of growth and renal function in young CRF patients.
Purpose:
- To analyze clinical characteristics, growth evolution, and glomerular filtration rate in children with CRF.
- To identify common etiologies and initial clinical features of pediatric CRF.
- To assess the progression rate of renal failure and its impact on growth.
Summary:
- The study analyzed 22 pediatric patients (<14 years) with CRF (GFR: 32.6 ± 24.8 ml/min/1.73 m²), followed for a mean of 3.5 years.
- Recurrent urinary tract infections (27%) and obstructive uropathies (41%) were the most frequent initial findings and etiology, respectively.
- Renal failure progressed faster in children with glomerulonephritis. One in three had short stature at diagnosis, with no significant change in growth delay by follow-up.
Impact:
- Provides insights into the clinical presentation and progression of chronic renal failure in children.
- Highlights the importance of addressing initial causes like UTIs and obstructive uropathies.
- Suggests that while growth delay is present at diagnosis, it may not significantly worsen over the follow-up period in this cohort.
Abstract:
Clinical characteristics, evolution of growth, and glomerular rate were analysed in 22 patients, younger than 14 years, with chronic renal failure (glomerular filtration rate: 32.6 +/- 24.8 ml/min/1.73 m2, x +/- DS) with a minimal follow-up of 6 months (3.5 +/- 3.3 years). Recurrent urinary tract infections were the most common initial clinical features (27%) and obstructive uropathies constituted the most frequent etiology (41%). Renal failure progression rate, which was assessed by means of 1 to serum creatinine concentration ratio, was faster in the group of children with glomerulonephropaties. At the diagnosis, one out of 3 children had short stature. At the end of the follow-up time, the delay of growth did not significatively modified (-1.6 +/- 2.2 DS versus -2.1 +/- 1.2 DS, p greater than 0.05).