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Chronic renal failure in children: analysis of main causes and deterioration rate in 81 children
Insights
In children, obstructive uropathies and renal hypoplasias cause early-onset chronic renal failure (CRF). Identifying congenital nephropathies is key to preventing CRF progression and end-stage renal disease.
Area of Science:
- Pediatric Nephrology
- Renal Pathology
Background:
- Chronic renal failure (CRF) in children presents diverse etiologies.
- Understanding the onset and progression based on cause is crucial for pediatric kidney disease management.
Purpose of the Study:
- To analyze the causes, age at onset, and deterioration rates of CRF in pediatric patients.
- To evaluate the impact of underlying renal conditions on CRF progression in children.
Main Methods:
- Retrospective study of 81 children (2 months–18 years) with CRF.
- Categorization of CRF causes: obstructive uropathies, glomerulopathies, renal hypoplasias, hereditary/vascular nephropathies.
- Analysis of age at clinical onset and rate of disease deterioration.
Main Results:
- Obstructive uropathies (42%) and glomerulopathies (27%) were the leading causes of pediatric CRF.
- Obstructive uropathies and renal hypoplasias presented with significantly earlier onset (2.8 and 2.4 years) compared to glomerulopathies (10.7 years).
- Deterioration was faster in glomerulopathies (4.1 years) and renal hypoplasias (4.2 years) than obstructive uropathies (6.7 years). Half reached end-stage renal disease within six years.
Conclusions:
- Congenital anomalies like obstructive uropathies and renal hypoplasias are major drivers of early-onset pediatric CRF.
- Focusing on the etiopathogenesis of congenital nephropathies is essential for preventing CRF.
- Current corrective procedures showed limited impact on the final outcome of pediatric CRF.
Abstract:
Cause of chronic renal failure (CRF), age at clinical onset, and deterioration rate were studied in 81 unselected children 2 months to 18 years old who were referred to UM-JMH during a six-year period. Obstructive uropathies caused 42%, glomerulopathies 27%, renal hypoplasias 15%, and hereditary and vascular nephropathies 8%. Age at clinical onset of CRF was significantly lower in patients with obstructive uropathies (2.8 years) and renal hypoplasias (2.4 years) than in glomerulopathies (10.7 years). Deterioration rate correlated with cause of CRF; it was more rapid in primary glomerulopathies (4.1 years) and renal hypoplasias (4.2 years) than in obstructive uropathies (6.7 years). Within the six-year period, half the patients studied reached end-stage renal disease (ESRD). Final outcome did not seem to be modified significantly by corrective procedures. These findings suggest that major efforts should be directed toward identification of the etiopathogenesis of congenital nephropathies to prevent occurrence of CRF.