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


OBJECTIVE
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.


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.
Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran. ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Alaleh
A
Gheissari
Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Saeedeh
S
Hemmatzadeh
Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran. ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Alireza
A
Merrikhi
Faculty of Nursing and Midwifery. Isfahan University of Medical Sciences, Isfahan, Iran.
Sharareh
S
Fadaei Tehrani
Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran. ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Yahya
Y
Madihi
Children; Chronic kidney disease; Hypertension; Incidence