Chronic Renal Failure in Children in Saudi Arabia

Abstract

This study includes 100 children (male to female ratio, 65:35) with chronic renal failure referred to our renal unit from different parts of the Kingdom over a period of three years. Their ages ranged from 1 to 13 years with a median age of 4 years. Malformations of the urinary tract were the most common cause of chronic renal failure (N = 34) followed by heredofamilial disorders (N = 18), renal hypoplasia/dysplasia (N = 17), glomerulopathies (N = 14), and miscellaneous diseases (N = 5). No diagnosis could be made in 12 patients because of late referral. Of the 40 patients treated for terminal renal failure, 22 are on maintenance dialysis, 13 on continuous ambulatory peritoneal dialysis, and nine on hemodialysis; nine patients have undergone transplantations, seven died, and two were discharged home on conservative treatment. The outlook for children with chronic renal failure (CRF) has changed over the last two decades, largely due to the advances made in dialysis and organ transplantation. Children who not very long ago would have faced certain death can now be treated and rehabilitated, so that they can become useful members of the society.Epidemiological studies of the disease in children are important in order to plan for their special medical requirements, including dialysis and organ transplant facilities. The subject has been researched and discussed extensively in many countries, but very little information is available from the Kingdom of Saudi Arabia. The purpose of this study was to identify the common causes of CRF, assess the problems related to its treatment, and discuss the therapeutic modalities available locally. Patients and DefinitionsThe study included 100 children with CRF referred to our renal unit from different parts of the Kingdom over the last three years. Neonates who died soon after birth due to severe renal impairment as in Potter's syndrome were excluded from the study. The definitions used were as follows:1,2 chronic renal failure (CRF): irreversible increase of serum creatinine levels to more than 180 µmol/L (2 mg/dl); preterminal renal failure: CRF before reaching terminal renal failure; ter minal renal failure: CRF requiring dialysis or transplantation or leading to death. ResultsFifty-seven (57%) patients were less than 6 years old on admission and this included 22 children younger than a year (Table 1). Seventy-six (76%) children were Saudis and the remaining 24% were children of Arab expatriates

Chronic renal failure in Kuwaiti children: an eight-year experience

“…Home deliveries, which were common in the 1950s and 1960s, have been prohibited by the legal authorities in Kuwait, and this has dramatically reduced the chances of missing the detection of a congenital renal anomaly or of a late diagnosis. Our patients were much younger than those reported in studies in other parts of the world [17,18,19,20], with patients less than 5 years of age at diagnosis constituting 56% of the subjects. The onset of CRF during the first year of life was observed in 27% of the patients, confirming the importance of diagnosing congenital urinary anomalies early in life.…”

“…Both these families were Kuwaiti. Glomerulopathies constituted only 5.2% of our CRF patients, which was markedly lower than the rates reported in other studies [6,7,10,17,20,22]. This is most likely due to the relatively young ages of our patients.…”

Prognostic factors in Saudi children with posterior urethral valves

“…It is estimated that renal failure develops in up to 30% of patients [1]. In our population PUV accounts for about 17% of children with chronic renal failure [2]. Such large numbers of children with PUV progressing to chronic renal failure place a strain on the resources available for health care, especially in countries with limited resources.…”

Aetiology of Paediatric End Stage Renal Failure in Jordan: A Multicenter Study

“…In our study, reflux nephropathy was the second cause of ESRF in childhood which was similar to the North American Paediatric Renal Trials and Collaborative Studies [NAPRTCS] (15). The contribution of posterior urethral valve was higher in Saudi Arabia [17%] (16) and rare in Slovakia [0.8%] (13). Renal hypo/dysplasia was responsible for 12.4% of cases of ESRF, which is comparable to Kuwait [14.6%] (5).…”