El-Reshaid K, Kapoor M M, Nampoory M R, El-Reshaid W, Johny K V
Department of Medicine, Faculty of Medicine, Kuwait University, Safat.
Pediatr Nephrol. 1999 Apr;13(3):259-64. doi: 10.1007/s004670050605.
Data on end-stage renal disease (ESRD) patients and their renal replacement therapy (RRT) were collected retrospectively from the three dialysis centers, the pediatric urology unit, and the organ transplant center of Kuwait. The study period was from 1 January 1986 to 31 December 1996. A total of 61 children, 50 of whom were Kuwaiti nationals, required RRT for ESRD during those 11 years. This gave an average annual incidence rate of 18 per million Kuwaiti children. Glomerulonephritis was the most-frequent underlying disease and accounted for 44% of total cases, while pyelonephritis (including urinary tract anomalies and dysplastic kidneys) was responsible for 30%. Multisystem disease was responsible for ESRD in 7 patients (14%), 2 of whom had lupus nephritis, 2 vasculitis, 2 Henoch-Schönlein purpura, and 1 hemolytic uremic syndrome. Continuous ambulatory peritoneal dialysis and home intermittent peritoneal dialysis, using cycler machines, were not favored dialysis techniques by most parents, especially for those <6 years old. The actuarial survival on dialysis was 75%+/-7% at 12 months. Of the 8 patients who died, 7 were <6 years old. Thirty-eight patients received 46 kidney transplants, 13 of which were performed on a pre-emptive basis. The actuarial patient survivals at 12 months for those receiving first live and cadaveric kidney transplants were 90%+/-5% and 85%+/-2%, respectively, while those for grafts were 76%+/-8% and 66%+/-2%, respectively. This is the first nationwide long-term study of the incidence and etiology of pediatric ESRD in our area and the RRT in a country with adequate treatment facilities.
我们从科威特的三个透析中心、儿科泌尿外科和器官移植中心回顾性收集了终末期肾病（ESRD）患者及其肾脏替代治疗（RRT）的数据。研究时间段为1986年1月1日至1996年12月31日。在这11年期间，共有61名儿童因ESRD需要进行RRT，其中50名是科威特公民。这使得科威特儿童的年平均发病率为每百万18例。肾小球肾炎是最常见的基础疾病，占总病例的44%，而肾盂肾炎（包括尿路畸形和发育不良的肾脏）占30%。多系统疾病导致7例患者发生ESRD（14%），其中2例患有狼疮性肾炎，2例患有血管炎，2例患有过敏性紫癜，1例患有溶血尿毒综合征。持续非卧床腹膜透析和使用循环机进行的家庭间歇性腹膜透析，并非大多数家长青睐的透析技术，尤其是对于6岁以下的儿童。透析12个月时的精算生存率为75%±7%。在8例死亡患者中，7例年龄小于6岁。38例患者接受了46次肾移植，其中13次是在有优先移植机会的情况下进行的。接受首次活体和尸体肾移植患者12个月时的精算生存率分别为90%±5%和85%±2%，而移植肾的精算生存率分别为76%±8%和66%±2%。这是我们地区关于儿科ESRD发病率和病因以及在一个拥有充足治疗设施国家进行RRT的第一项全国性长期研究。
