Clinical and laboratory features of our children with chronic renal failure at the first time of diagnosis

Introduction and Aim: Chronic renal failure(CRF) in childhood period is an important social and economical problem. Primary renal disorders varies according to age and geographical area. Congenital structural anomalies and hereditary nephropathies occupy majority of CRF in childhood. Determining the etiologic factor of End Stage Renal Disease (ESRD), earlier diagnosis of prevantable and treatable disorder and distinguishing special disease that would reccur in posttransplant period plays crucial role in the managment of CRF. In this study, we evaluated demographic features such as; age at the time of diagnosis, duration of disease, delay in the dignosis, growth failure, physical examination blood pressure, laboratorial and diagnostic findings of children with CRF in our region.Material and Methods: 50 patients with CRF were enrolled to the study and recordings were examined retrospectively. Age at the time of diagnosis, height, weight, percetile of height and weight, blood pressure, laboratorial and renal ultrasonographic findings, duration and etiology of CRF were recorded.Findings: 26 female (52 %) and 24 male (48 %) patients with CRF diagnosed between 2004 and 2009 were enrolled to the study. Age of patients were between 1-16 years and mean age was 10.07±4.4 years. Most frequent etiologic cause of CRF was idiopathic for both male and female patient. However second frequent cause was vesicouretheral reflux for female and neurogenic bladder and nephrolitiazis in same frequency for male patients. Of these 50 patients; 11 patients were 5 years and below, 39 patients were upper 5 years of age (16 boys, 23 girls). Number of 34 patients at initial presentation had severe chronic renal failure with a GFR (Glomurular Filtration Rate) of 30 ml/minute/1.73 m2 (stage 4, 5). The median presentation GFR was 22.6±13.9 ml/min/1.73 m2 .Results: Etiologic disorders vary according to follow and results of CRF or ESRD. Researches examing the frequency of ESRD could not reveal out exact case of CRF in childhood, because majority of children with CRF progress to ESRD in adulthood period. Also etiologic cause of CRF varies according to age, geographical region, economical state and health politics of country. Etiological and epidemiological studies are required to regulate renal replaccment therapy program for CRF in childhood period. This efforts would provide to diminish the frequency of preventable cases of CRF. We suggest that delay in the diagnosis of CRF is related insufficient follow up programs due to social or personal reasons. Lack of regular units by pediatrist or first step health clinician is the major case of delay in the time of diagnosis.Key Words: Childhood, Chronic Renal Failure, Epidemiology, Etiology, Glomurular Filtration Rate.