Objective Over the past 10 years, we have collected data on pediatric patients less than 16 years of age from the National Registry of CAPD (continuous ambulatory peritoneal dialysis). We present our experience with this population. Design The database details the patient number, age, weight, height, outcome, cause of death, reason for terminating CAPD therapy, peritonitis, and catheter survival. Patients Of the 434 patients (239 males, 195 females), 37 patients (8.5%) were under 1 year of age and 164 patients (37.8%) were under 6 years of age. About half of the patients were less than 20 kg in weight, clearly indicating that CAPD was the treatment of choice in young children. The duration on CAPD for these patients was less than 2 years for 233 patients (54%), and was 5 years or more in 48 patients (11%). Results The outcome of the total patient population of 434 as of M ay, 1991, is as follows 229 patients (52.8%) were being successfully treated with CAPD, 47 patients (10.8%) died, and 78 patients (18.0%) received a kidney transplantation. The patient survival rate was 85.6% at 3 years and 81.7% at 5 years. The technique survival rate was 74.9% at 3 years and 63.5% at 5 years. The rate of peritonitis was one episode over 28.6 patient-months. The mean catheter duration was 1.68 years. Peritonitis rate, catheter survival rate, and the rate of tunnel infection were worse in children less than 6 years of age than in older children. Conclusion The excellent patient and technique survival rates indicate that CAPD is an effective treatment for children with end-stage renal disease in Japan. The high infection rates in younger children indicate that extra careful management is needed for this young age group.

There were no fatalities, and the proportion of patients with serious illness was substantially lower than previously reported from other countries. Good access to medical services and proactive treatment may have contributed to the lower disease burden of the 2009 influenza pandemic on Japanese children.

We performed an epidemiologic study on the basis of a questionnaire survey of 162 children with end‐stage renal disease (ESRD). Sixty‐nine (43%) of our 162 children, including 25 detected at mass screening of urine, were found by chance hematuria and/or proteinuria. The three major causes of ESRD in our children were chronic glomerulonephritis (CGN) in 56, congenital anomalies of the urinary tract in 30, and nephrotic syndrome (NS) in 27. The renal pathology in 39 children with CGN or NS was focal glomerular sclerosis in 15, diffuse mesangial GN in 7, IgA GN in 5, membranoproliferative GN in 3, membranous GN in 3, and unclassified in 6. Forms of dialysis initiated were hemodialysis in 91 children, continuous ambulatory peritoneal dialysis (PD) in 66, and intermittent PD in 5. Renal transplantation was performed on 38 children, and the graft and the patient survival rates were 76% and 89%, respectively. The survival rate of our 162 children for a mean follow‐up of 8.1 years was 77%. In conclusion, an integrated program of maintenance dialysis and transplantation provides a favorable life for children with ESRD.

We evaluated the clinicopathological features and the outcome of 33 children with primary glomerulonephritis (GN) as the cause of renal failure; 17 had asymptomatic (ASP) haematuria and/or proteinuria and the remaining 16 had symptoms suggestive of GN. The renal histology in the ASP group indicated IgA GN in 6 children, focal segmental glomerular sclerosis (FSGS) in 4, diffuse proliferative GN (DPGN) in 3, membranous GN (MGN) in 1, membranoproliferative GN (MPGN) in 1 and diffuse sclerosing GN in 2. In the symptomatic (SYP) group, FSGS was evident in 9 children, DPGN in 3, MGN in 2, IgA GN in 1 and MPGN in 1. There was no difference in the histological severity between the two groups. Fourteen children in the SYP group had nephrotic syndrome (NS) and/or hypertension at their initial visits. Only 4 children in the ASP group showed NS or hypertension during the period of follow-up. Eleven children in the ASP group and all in the SYP group were treated with immunosuppressive and/or antihypertensive drugs, but these did not improve the prognosis of the ASP children compared with those in the SYP group. There was no significant difference in the mean duration between the onset of the disease and the start of dialysis in these two groups. In conclusion, it is questionable whether the urinary mass screening programme in Japan will alter the outcome of children with GN.