Gheissari Alaleh, Hemmatzadeh Saeedeh, Merrikhi Alireza, Fadaei Tehrani Sharareh, Madihi Yahya
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.
Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Nephropathol. 2012 Oct;1(3):177-82. doi: 10.5812/nephropathol.8119. Epub 2012 Oct 1.
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.
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.
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.
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).
We concluded that glomerular diseases are the leading cause of CKD in our patients. In addition, the annual incidence of CKD is considerably high.
慢性肾脏病（CKD）是儿童中的一种严重疾病。鉴于CKD在儿童年龄组中的重要性，除了CKD患病率和病因的种族及民族差异外，建议开展流行病学研究。关于CKD发病率的大多数结果来自对住院儿童的研究。
本研究评估伊朗第二大省伊斯法罕一家三级医疗中心儿童慢性肾衰竭（CRF）的发病率和病因。
对2001年11月至2011年12月期间在伊朗伊斯法罕圣阿尔扎赫拉医院因CKD住院的19岁以下儿童的病历数据进行回顾性分析。共纳入268例符合条件的病例。根据肾小球滤过率（GFR）和KDOQI指南将患者分为5组。
268例患者中，144例为男性（54%）。年龄均值和中位数分别为11.01±0.39（标准差）岁和12.5岁。约55%的患者患有收缩期和/或舒张期高血压。CKD最常见的病因是肾小球疾病（34%），其次是反流性肾病（16.7%）。大多数患者（74.8%）确诊时GFR低于15 ml/min/m²。贫血是最常见的实验室异常（85%）。65.8%的患者可见肾脏体积缩小。72.3%的患者接受了肾脏替代治疗（血液透析或腹膜透析）。移植率平均为每百万儿童人口7.2例。CKD（大多为晚期）的年发病率分别为每百万人口5.52例（PMP）和每百万儿童人口16.8例。全因死亡率为18.4%。年龄较小是死亡率的唯一独立预测因素（p = 0.005）。
我们得出结论，肾小球疾病是我们患者中CKD的主要病因。此外，CKD的年发病率相当高。
