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J Nephropathol. 2012;1(3): 177-182.
doi: 10.5812/nephropathol.8119
PMID: 24475412
PMCID: PMC3886143
Scopus ID: 84872703480
  Abstract View: 8236
  PDF Download: 4279

Original Article

Chronic kidney disease in children: A report from a tertiary care center over 11 years.

Alaleh Gheissari 1,2*, Saeedeh Hemmatzadeh 3, Alireza Merrikhi 1,2, Sharareh Fadaei Tehrani 4, Yahya Madihi 1,2

1 Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Faculty of Nursing and Midwifery. Isfahan University of Medical Sciences, Isfahan, Iran.
*Corresponding Author: *Corresponding author: Dr. Alaleh Gheissari, Child Growth and Development Research Center. Isfahan University of Medical Sciences.Isfahan, Iran. Telephone/Fax: +983112502430, , Email: gheisari@med.mui.ac.ir

Abstract

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.


Implication for health policy/practice/research/medical education:

Chronic kidney disease (CKD) is an overwhelming illness in children. This study evaluates the incidence and etiology of CKD in children in a tertiary care center in Isfahan, Iran. We found that, glomerular diseases are the leading cause of CKD in our patients. In addition, the annual incidence of CKD is considerably high.

Please cite this paper as: Gheissari A, Hemmatzadeh S, Merrikhi A, Fadaei Tehrani S, Madihi Y. Chronic Kidney Disease in Children: A report from a tertiary care center over 11 years. J Nephropathology. 2012; 1(3): 177-182. DOI: 10.5812/nephropathol.8119

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Revision: 25 May 2012
ePublished: 01 Oct 2012
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