Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 5-6, Pages: 313-320
https://doi.org/10.2298/SARH1206313P
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Chronic kidney disease during a 12-year period at tertiary health institution
Paripović Aleksandra (Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Stajić Nataša (Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Putnik Jovana (Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Bogdanović Radovan (Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Introduction. Chronic kidney disease (CKD) is a significant cause of
morbidity and mortality in paediatric population. Objective. The aim of the
study was analysis of aetiology, staging and associated complications of CKD
at the time of diagnosis. Methods. Data of 97 patients (56 boys) of average
age 7.8±5.8 years, referred for the first time to the Institute for Mother
and Child Healthcare „Dr Vukan Čupić”, Belgrade in the period 1998- 2009, due
to CKD, stage 2-5, were analysed. In each patient illness history was
obtained, and physical examination, laboratory, X-ray and other
investigations were performed according to the indications. CKD was
classified according to the glomerular filtration rate into four grades: 2 -
mild (60-90 ml/min/1.73 m2); 3 - moderate (30-60 ml/min/1.73 m2); 4 -
advanced (15-30 ml/ min/1.73 m2); and 5 - terminal (<15 ml/min/1.73 m2).
Results. The most frequent causes of CKD were congenital anomalies of the
kidney and urinary tract (43.3%), followed by glomerular diseases (17.5%),
hereditary kidney diseases (16.5%), metabolic diseases (7.2%) and other
causes (15.5%). Mild CKD was found in 29.8%, moderate in 28.9%, advanced in
22.7%, and terminal in 18.6% children. Among patients with CKD stage 4 and 5,
75% of patients presented with acute renal failure, while 25% had earlier
detected CKD (stage 1), but were not under regular follow-up. Associated
complications included metabolic acidosis (63%), anaemia (60%), hypertension
(42.3%), short stature (25.8%), renal osteodystrophy (13.4%) and
cardiovascular diseases (7.2%). Conclusion. Congenital anomalies of the
kidney and urinary tract are the leading cause of CKD in paediatric
population. A significant proportion (41.3%) of patients had advanced and
terminal CKD. In most patients CKD was diagnosed late and with associated
complications.
Keywords: chronic kidney disease, aetiology, associated complications, children