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[Chronic renal insufficiency in the child. Etiology, development and prognosis]
Insights
This study analyzed 147 children with chronic renal failure (CRF), finding urinary tract malformations and glomerular diseases were common causes. The progression of renal failure varied significantly based on the underlying kidney disease.
Area of Science:
- Pediatric Nephrology
- Renal Pathology
Context:
- Chronic renal failure (CRF) affects children, necessitating understanding of its causes and progression.
- 147 pediatric patients with CRF (creatinine clearance < 50 ml/min/1.73 m2) were analyzed.
Purpose:
- To determine the distribution of primary renal diseases in pediatric CRF.
- To analyze the natural history of renal failure based on etiology.
- To evaluate long-term survival in children with CRF.
Summary:
- Urinary tract malformations (38%) and glomerular pathology (26%) were the leading causes of CRF in children.
- Hereditary renal diseases (20%) and renal hypoplasias (11%) also contributed significantly.
- Renal failure progression differed by etiology: slow deterioration for uropathy/hypoplasia, steady decline for nephronophtisis, and rapid decline for glomerular diseases.
Impact:
- Provides etiological insights into pediatric chronic renal failure.
- Highlights the variable natural history of renal failure, guiding prognosis and management.
- Informs clinical practice and research priorities in pediatric nephrology.
Abstract:
Our study concerned 147 children with chronic renal failure (CRF) (creatinine clearance less than 50 ml/min/1.73 m2). Its goal was to analyse the distribution of primary renal diseases, natural history of renal failure (RF) according to etiology, and long term survival. Renal diseases responsible for RF were: malformations of the urinary tract (38%), glomerular pathology (26%), hereditary renal diseases (20%), isolated renal hypoplasias (11%), and miscellaneous (5%). Corticoresistant nephrosis accounted for 34% of glomerular diseases and nephronophtisis 63% of hereditary renal diseases. On the whole, RF was related with an uropathy or renal hypoplasia in half of cases and with congenital renal disease in almost 3/4 of cases. The natural history varied according to primary renal disease: slow deterioration after a period of relative stability for uropathy or renal hypoplasias, slow and regular deterioration for nephronophtisis, rapid deterioration for glomerular diseases.