THE ETIOLOGIC EVALUATION IN PATIENTS WITH CHRONIC RENAL FAILURE

A retrospective analysis of pediatric cases of chronic renal failure (CRF) was performed at our hospital over 2 years period. The diagnosis of CRF was based on gomerular filtration rate less than 50 ml/min per 1.73 m2 body surface or serum creatinine above 1 mg/dlfor ehilden younger than 3 years, 1.5 mg/dl for 3- 10 years and 2 mg/dl for older than 10 years for at least 6 months. End stage renal failure (ESRF) was defined as a serum creatinine concentration four or five times higher than normal values for age and gender, or a GFR below 10 ml/min per 1.73 m 2 body surface. There were a total of 50 patients (23 girls and 27 boys) with a mean age 10.9±4.1 years (range 2 months to 17 years). The etiology of CRF included reflux nephropathy 20 (40 %), glomerulonephritis 20 (40 %), hereditary renal disease 5 (10 %), urolithiasis 4 (8 %) and hypo/dysplastic kidney 1 (2 %). 23 patients had end stage renal disease, 12 of them were on hemodialysis and 11 on peritoneal dialysis. 27 patients had preterminal renal failure and were on conservative treatment. Eight patients died and 2 had undergone renal transplantation.

11 (22 %) of 24 patients with reflux nephropathy and urolithiasis had a history of recurrent urinary tract infections and had already been treated in primary health care centers.

Our findings, compared with the European data, showed a higher frequency of urinary tract abnormalities and urinary tract infections as a primary cause of CRF in children. Thus it is important to diagnose and threat urinary tract infections as early as possible in the primary care centers. Epidemiological and etiological studies are important for the renal replacement programs.