Résumé
Chronic renal failure is defined as progressive and irreversible loss of renal functions that gradually progress to end-stage renal disease. The etiology of chronic renal failure in childhood correlates closely with the age of patient at the time when the renal failure is first detected. The aim was to assess the underlying causes and risk factors of chronic renal failure and to identify the clinical presentation of chronic renal failure in children reporting at Allied Hospital Faisalabad. It was a cross sectional study. The study was done in a period of one year starting from March 20th, 2007 to March 20, 2008. The study was done in the Department of Pediatrics medicine Allied Hospital Faisalabad. CRF was defined as glomerular filtration rate less than 25% of the normal for that age and sex. Patients of either sex ranging from 6 months to 15 years fulfilling the inclusion criteria were included in this study. Sampling technique was non-probability convenience sampling. In addition to clinical evaluation, they were investigated to find out the underline causes. Out of 40 patients of CRF males were [n-28], females were [n-12], with male to female ratio of 2.3:1. Mean age of males was 7.36+ 3.98 and females was 8.96+ 2.65. Etiological factors found in 34[85%] patients included congenital malformations [9-22.5%] urolithiasis [8-20%] reflux nephropathy [6-15%] glomerulopathies [3-7.5%] neurogenic bladder [2-5%] strictures [1-2.5%] and miscellaneous [5-20.5%] Etiology was unknown in 6 patients [15%]. Failure to thrive 77%, Respiratory distress 75%, Pallor 75%, Fever 75%, Headache 67%, Vomiting 63%, Edema 50%, and Anorexia 42% were the most common clinical features at presentation
Résumé
To evaluate the various types of congenital heart defects and to determine their frequency in children with Down's syndrome. Descriptive study. Department of Pediatrics, Independent University Hospital Faisal Abad Pakistan, from January 2010 to December 2012. 93 children between the ages of day 1 to 12 years, diagnosed clinically as Down's syndrome based on its characteristic phenotypic appearance, were included in the study. A detailed history, physical examination and evaluation of cardiovascular status [including Chest x-ray, Electrocardiogram and Echocardiography] were performed in each Down's syndrome case. Variables of interest included age, sex, maternal age at birth and type and frequency of congenital heart disease. Congenital heart disease was present in 48 [51.62%] children out of 93 children with Down's syndrome. Congenital cardiac defects in order of predominant type and their frequency included Ventricular septal defect [29, 60.4%], Atrioventricular septal defect [14, 29.1%], Atrial septal defect [2, 4.1%], Patent ductus arteriosis [2, 4.1%] and Tetralogy of Fallots [1, 2%]. 68 [73.2%] Down's syndrome children [n=93] presented during their first year of life with mean age of 7 +/- 4 months. Male predominance was observed in both with and without congenital heart disease Down's syndrome children [male: female 1.7:1 and 2.5:1 respectively]. Mean maternal age at birth was 27 +/- 2 years. Congenital heart disease [CHD] is frequently associated with Down's syndrome [DS]. Ventricular septal defects and atrioventricular septal defects are the most common forms of CHDs in DS children of our region. Their earlier presentation [in infancy] and significant contribution to the morbidity and mortality of DS children warrants early diagnosis of DS and mandatory screening of all DS children for associated CHDs