Etiology of chronic renal failure in children; experience at king Hussein medical center

ABSTRACT

To determine the spectrum and etiology of chronic renal failure, for patients followed up in the pediatric nephrology clinic at King Hussein Medical Center, as well as to determine the prevalence and other demographic features for patients with chronic renal failure in Jordan. A registry analysis of all children with chronic renal failure followed in the pediatric nephrology clinic at King Hussein Medical Center during the year 2004 was conducted. Chronic renal failure was defined as having glomerular filtration rate <80 ml/ min / 1.73m[2]. Demographic data such as sex, height, and date of birth, as well as the serum BUN, creatinine, diagnosis and the duration of chronic renal failure at the time of follow up were all recorded. Chronic renal failure was calculated from serum creatinine based on Schwartz formula. CRF was divided to 4 stages according to the Kidney Disease Outcomes Quality Initiatives guidelines, for stratification of chronic kidney disease. A total number of 117 patients, 64 [54.7%] males, and 53 [45.3%] females were included in the study. Statistical Package for Social Studies version 10 was used to analyze the data. Values are given in means +/- standard deviation unless otherwise stated. The mean age was 8.6 +/- 4.7 years, and the mean duration of follow up was 6.7 +/- 2.3 years. The mean glomerular filtration rate for the whole study population at the time of recording was 28.6 +/- 19.58 ml/min/ 1.73m[2]. It was shown that the prevalence of chronic renal failure among Jordanian children in the year 2004 to be 75 patients per million-child population. The most common cause of chronic renal failure was Reflux Nephropathy [30.8%] of total, followed by Neurogenic Bladder [17.9%]. Reflux Nephropathy, and Obstructive Uropathy were more common in males when compared to females; where as Neurogenic Bladder and Hemolytic Uremic Syndrome were more common in females. The most common cause of chronic renal failure in patients with end stage renal disease at King Hussein Medical Center was glomerulonephritis [19.4%], followed by oxalosis [16.1%].The etiology of chronic renal failure in Jordan is similar to other places with some peculiar features that need further study including the high prevalence of neurogenic bladder, and oxalosis. The importance of establishing a national and possibly regional registry system for pediatric chronic renal failure is well illustrated by this study