Wannous Hala, Albalkhi Asshaar
Faculty of Medicine, Damascus University, Damascus, Syria.
Children's University Hospital, Damascus University, Damascus, Syria.
Pediatr Nephrol. 2025 May 26. doi: 10.1007/s00467-025-06817-y.
Chronic kidney disease (CKD) is a condition marked by permanent kidney damage, which can eventually advance to kidney failure. Our study aimed to identify CKD causes and investigate the risk factors for CKD progression in Syrian children.
A single-center observational cohort study was conducted at Children's University Hospital in Damascus, included all patients admitted to the department of pediatric nephrology (inpatient unit) from February 2022 to February 2023, with CKD stages 2-5.
Our study included 100 patients, with a slight female predominance, and mean age of 4.73 years ± 3.7, ranging from 3 months to 14 years. CKD causes were congenital anomalies of the kidney and urinary tract (CAKUT) in 79%, hereditary nephropathies in 12%, and glomerular diseases in 9%. After one year of follow-up, 38% of them were stable on conservative management and 62% had kidney failure. Gender, age, and family history of CKD were not statistically significant factors in CKD progression. The progression rate to kidney failure was highest in glomerular diseases, with 100% for glomerulonephritis and 80% for steroid-resistant nephrotic syndrome, and the progression rate in kidney dysplasia patients was 78.1%. Proteinuria, metabolic acidosis, hyperparathyroidism, hypertension, anemia, and hyperphosphatemia were significantly associated with CKD progression.
In Syrian children, CAKUT are the leading cause of CKD. CKD progression is most rapid in glomerular diseases. Modifiable risk factors, especially hypertension and proteinuria, play a significant role in CKD progression, which highlights the importance of early detection and appropriate management of these factors.
慢性肾脏病（CKD）是一种以永久性肾损伤为特征的疾病，最终可能发展为肾衰竭。我们的研究旨在确定叙利亚儿童CKD的病因，并调查CKD进展的危险因素。
在大马士革的儿童大学医院进行了一项单中心观察性队列研究，纳入了2022年2月至2023年2月期间儿科肾脏病科（住院部）收治的所有2-5期CKD患者。
我们的研究纳入了100例患者，女性略占优势，平均年龄为4.73岁±3.7岁，范围从3个月至14岁。CKD的病因中，79%为先天性肾脏和尿路畸形（CAKUT），12%为遗传性肾病，9%为肾小球疾病。随访一年后，38%的患者在保守治疗下病情稳定，62%的患者出现肾衰竭。性别、年龄和CKD家族史在CKD进展中不是统计学上的显著因素。肾小球疾病进展至肾衰竭的比例最高，肾小球肾炎为100%，激素抵抗型肾病综合征为80%，肾发育不良患者的进展比例为78.1%。蛋白尿、代谢性酸中毒、甲状旁腺功能亢进、高血压、贫血和高磷血症与CKD进展显著相关。
在叙利亚儿童中，CAKUT是CKD的主要病因。肾小球疾病中CKD进展最快。可改变的危险因素，尤其是高血压和蛋白尿，在CKD进展中起重要作用，这突出了早期检测和适当管理这些因素的重要性。
