Etiology and outcome of chronic kidney disease in Iranian children

Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 -2014. Children (186 boys, 186 girls) with Stage 3 to 5 CKDs, defined as a glomerular filtration rate below 60 ml/min per 1.73 m2body surface area, were identified. Results Etiology was congenital anomalies of the kidney and urinary tract in 125 (33.60%), cystic/ hereditary/ congenital diseases in 91 (24.46%), glomerulopathy in 73(19.62%), and cause unknown in 71 (19.09%) patients. Forty-eight (13.22%) were on conservative treatment, 174(47.93%) had end-stage renal disease (ESRD) with chronic hemodialysis, 24 (6.61%) were on continuous ambulatory peritoneal dialysis. Sixty-eight (18.74%) underwent on renal transplant which was successful in 52 (14.33%) patients but was associated with abnormal renal function in 16(4.41%) children. Finally, 49 (13.50%) patients died. Conclusion A large number of children developed CKD secondary to congenital anomalies of the kidney and urinary tract. Planning for screening, early detection and instituting timely treatment of preventable causes could lead to a lower incidence of CKD in this group of children.