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 Cupić", 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.