Etiology of Pediatric Chronic Kidney Diseases in North-West of Iran

Abstract

The aim of this study was to evaluate the etiology of pediatric Chronic Kidney Disease (CKD) in a tertiary care hospital in north-west of Iran. Medical records of admitted children with CKD in Children's Hospital of Tabriz from 1999 to 2009 were studied retrospectively. CKD was defined as GFR less than 60 mL min(-1) 1.73 m2 for more than 3 month. The etiology of CKD was determined by clinical, biological, radiological and histopathological examination. During 10 years 115 children including 61 boys (53%) and 54 girls (47%) were studied. The mean age of patients was 8.1 +/- 3.53 years (range: 4 months to 14 years). Urological abnormalities were the most common cause of CKD (36.5%) followed by acquired glomerular diseases (23.5%), hereditary nephropathies (21.7%), unknown etiology (9.5%) and systemic diseases (6%). The most common urologic anomaly was vesicoureteral reflux (VUR) that accounted for 24.3% of total etiologies followed by obstructive uropathies. Focal segmental glomerulosclerosis was the most frequent glomerular disease and was responsible for 13.9% of patients. Nephronophtisis, cystinosis, infantile polycystic disease and congenital nephrotic syndrome were the most frequent hereditary nephropathies in a descending order. Frequency of parental consanguinity in patients with hereditary nephropathy was significantly higher than other patients (p = 0.001). High frequency of VUR in present study compared with developed countries necessitates more efforts for improving the management and follow up of urinary tract infections.

Causes of Chronic Kidney Disease in Iranian Children: A Meta-Analysis and Systematic Review

“…Of the 13 included studies, 5 were cross-sectional and 7 were retrospective studies. There were 13 studies obtained from 7 provinces: 4 from Tehran [14,[21][22][23], 2 from Fars [16,24], 2 from Isfahan [25,26], and 2 from East Azerbaijan [27,28]. One study was conducted in each of the provinces of Khuzestan [29], Khorasan Razavi [15], and Mazandaran [30].…”

The Fate of Patients Who Started Hemodialysis during Childhood or Adolescence: Results of an Interregional Moroccan Survey

“…In this survey, urological abnormalities (18%) are the most common causes of the ESRD. The urological abnormalities represents also the most found etiology in our country (34% of cases) as well as in different countries (USA 57% of cases, Italy 68% of cases, India 47% of cases, and Iran 52% of cases) [ 7 , 11 – 13 ]. Glomerular diseases (12.5% in this series) represent the second etiology of ESRD, with a very variable rate depending on the country.…”

“…In Morocco, the sex ratio is 1.25 for children under 19 years old [ 3 ]. These results can be explained by the high incidence of congenital anomalies of the kidney and urinary tract among boys (CAKUT) [ 1 , 5 , 7 ]. The average age of our patients as they started dialysis was 14.12 ± 3.4 years and only 3% of them were younger than 5 years.…”

“…This difference is due to a higher prevalence of infectious diseases [ 1 , 3 , 5 , 7 , 11 ]. Hereditary nephropathies (5.5%) represent a small percentage in comparison with other studies that found a higher incidence (we have nationally 17% of cases and Iran has 21.7%, Tunisia 29%, Italy 25%, Iraq 21.3%, and Jordan 29.7%) in relation with the frequency of intermarriages in these countries [ 4 , 7 , 8 , 12 ]. The etiologies we have found may be underestimated because of the very high percentage of unknown etiologies (54%) in this study in comparison with other studies.…”

Obstructive Uropathy Secondary to Posterior Urethral Valves: Retarding the Progression to End-Stage Kidney Disease in Children

“…In the United Kingdom, obstructive uropathy (mainly PUV) accounted for 14.9% of the cases; it ranks only behind renal dysplasia and glomerular disorders in the causative list [21]. In a hospital-based study in Iran, urologic anomalies were the most common cause of CKD in children; the most common anomaly was vesico-ureteral reflux (VUR) which accounted for 24.3% of total etiologies followed by obstructive uropathies [22]. Similarly in Iraq, Middle-East [23], Jamaica in the Caribbeans [24], as well as in Paraguay, South America [25], congenital urologic malformations were responsible for the majority of childhood CKD etiologies followed by glomerulonephritis.…”