[End-stage renal insufficiency in children less than 4 months old. Survey of the French Pediatric Nephrology Club].
One hundred and eleven cases of children with end-stage renal failure prior to 4 years of age were collected from a survey of the French Pediatric Nephrology Club. Clinical and epidemiological data stress the importance of certain etiologies such as 40 cases of renal hypoplasia. The necessity of planning extracorporeal dialysis from the first year of life in 37% of patients demonstrates the importance of difficulties to be overcome. The treatments used for the 82 treated children show the interest of conservative management. However, peritoneal dialysis remains the first treatment of choice (52 times). Besides the problems of hemodialysis vascular approach, related to the small caliber of vessels, the complications of the clearance techniques did not appear to be more frequent than in older children. Use of transplantation is not negligible as 25% of transplanted patients were under 4 years of age; however none was under one year or weighted less than 8 kg. Transplantation remains ultimate treatment, even more so as the actuarial survival at 5 years is clearly worse for children submitted to hemodialysis (68%) than to transplantation (91%) (p less than 0.05).
D003131:Combined Modality Therapy; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007668:Kidney / Q000002:abnormalities; D007674:Kidney Diseases / Q000150:complications; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012189:Retrospective Studies
D004044:Dietary Proteins
L'insuffisance rénale terminale chez les enfants de moins de 4 ans. Enquête du Club Français de Néphrologie Pédiatrique.