Related Experiment Videos
Worldwide demographic aspects of chronic renal failure in children
Insights
Chronic renal failure (CRF) incidence in children is underestimated, varying globally due to economic factors. Improved treatments increase prevalence, with glomerulonephritis being a leading cause.
Area of Science:
- Pediatric Nephrology
- Public Health
- Epidemiology
Background:
- The true incidence of chronic renal failure (CRF) in children is not well-established.
- Current estimates, based on dialysis-transplantation programs, likely underestimate the actual numbers.
- Global variations in incidence are linked to economic development and healthcare access.
Purpose of the Study:
- To analyze the incidence and causes of chronic renal failure in children.
- To discuss the challenges and potential improvements in managing pediatric CRF.
- To explore geographical and economic influences on pediatric CRF prevalence.
Main Methods:
- Review of existing data from dialysis-transplantation registries.
- Analysis of etiological factors in over 9400 pediatric cases.
- Comparison of incidence and prevalence trends across different countries.
Main Results:
- Pediatric CRF incidence varies widely, influenced by economic development.
- In developed nations, incidence is stable or decreasing due to early diagnosis and prevention, while prevalence rises with better treatment.
- Chronic primary glomerulonephritis is the most common cause, followed by pyelonephritis, obstructive uropathies, and vesico-ureteral reflux.
Conclusions:
- Accurate assessment of pediatric CRF incidence requires broader data collection beyond treatment programs.
- Addressing prevention, treatment access, therapy quality, and rehabilitation is crucial for improving outcomes.
- Geographical and economic disparities significantly impact pediatric end-stage renal disease (ESRD) management.
Abstract:
Incidence of chronic renal failure in children is not yet clearly known. In recent years it has been evaluated on the basis of the number of patients accepted into dialysis-transplantation programs and is thus underestimated, as registries do not list children who are not treated for technical reasons, lack of facilities or health policy. The number of new patients per year per million child population varies widely. Differences among countries are mainly related to economic development. In developed countries the incidence of CRF remains stable or decreases slowly owing to early diagnosis, improved conservative treatment, prevention of genetically-transmitted diseases, whereas the prevalence increases steadily as a consequence of improved replacement therapy. Causes of primary renal diseases have been analyzed in several series totaling over 9400 children. The most frequent cause is chronic primary glomerulonephritis followed by pyelonephritis, including obstructive uropathies and vesico-ureteral reflux. Differences in geographical distribution of etiologies are also analyzed. The relative contribution of chronic peritoneal dialysis and hemodialysis in the treatment of children with ESRF varies from country to country. Several problems regarding CRF in children are briefly discussed: prevention of renal failure, extension of treatment opportunities to more children, quality of replacement therapy, and clinical rehabilitation of children.