Hatay State Hospital, Pediatric Nephrology, Hatay, Turkey.
Hatay State Hospital, Pediatric Intensive Care, Hatay, Turkey.
J Bras Nefrol. 2022 Jan-Mar;44(1):68-74. doi: 10.1590/2175-8239-JBN-2020-0260.
Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the important causes of mortality and morbidity in childhood. Early diagnosis and treatment of the underlying primary disease may prevent most of CKD patients from progressing to ESRD. There is no study examining chronic kidney diseases and dialysis modalities in Syrian immigrant children. We aimed to retrospectively research the etiologic, sociodemographic, and clinical factors in CKD among Syrian refugee children, and at the same time, to compare the clinical characteristics of patients with ESRD on peritoneal dialysis and hemodialysis.
Our study included a total of 79 pediatric Syrian patients aged from 2-16 years monitored at Hatay State Hospital pediatric nephrology clinic with diagnosis of various stages of CKD and with ESRD. Physical-demographic features and clinical-laboratory information were retrospectively screened.
The most common cause of CKD was congenital anomalies of the kidneys and urinary tracts (CAKUT) (37.9%). Other causes were urolitiasis (15.1%), nephrotic syndrome (10.1%), spina bifida (8.8%), hemolytic uremic syndrome (7.5%), and glomerulonephritis (7.5%). Twenty-five patients used hemodialysis due to bad living conditions. Only 2 of the patients with peritoneal dialysis were using automatic peritoneal dialysis (APD), with 5 using continuous ambulatory peritoneal dialysis (CAPD). Long-term complications like left ventricle hypertrophy and retinopathy were significantly higher among hemodialysis patients. There was no difference identified between the groups in terms of hypertension and sex.
Progression to ESRD due to preventable reasons is very frequent among CKD patients. For more effective use of peritoneal dialysis in pediatric patients, the responsibility of states must be improved.
慢性肾脏病（CKD）和终末期肾病（ESRD）是儿童死亡和发病的重要原因之一。早期诊断和治疗潜在的原发性疾病可能会阻止大多数 CKD 患者进展为 ESRD。目前尚无研究探讨叙利亚移民儿童的慢性肾脏病和透析方式。我们旨在回顾性研究叙利亚难民儿童 CKD 的病因、社会人口统计学和临床因素，并同时比较 ESRD 患者行腹膜透析和血液透析的临床特征。
我们的研究共纳入了 79 名年龄在 2-16 岁的叙利亚儿科患者，这些患者在哈塔伊州立医院儿科肾病科接受监测，被诊断为各种阶段的 CKD 和 ESRD。回顾性筛选了他们的体格、人口统计学特征和临床实验室信息。
CKD 的最常见病因是肾和泌尿道先天异常（CAKUT）（37.9%）。其他病因包括尿路结石（15.1%）、肾病综合征（10.1%）、脊柱裂（8.8%）、溶血尿毒综合征（7.5%）和肾小球肾炎（7.5%）。由于生活条件差，25 名患者接受了血液透析。仅 2 名腹膜透析患者使用自动腹膜透析（APD），5 名使用持续不卧床腹膜透析（CAPD）。血液透析患者的长期并发症如左心室肥厚和视网膜病变明显更高。两组在高血压和性别方面无差异。
由于可预防的原因，CKD 患者进展为 ESRD 的情况非常普遍。为了在儿科患者中更有效地使用腹膜透析，国家的责任必须得到加强。
