Journal Article

Epidemiology of chronic kidney disease in children in Serbia

Amira Peco-Antić, Radovan Bogdanović, Dušan Paripović, Aleksandra Paripović, Nikola Kocev, Emilija Golubović and Biljana Milošević

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 5, pages 1978-1984
Published in print May 2012 | ISSN: 0931-0509
Published online November 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr556
Epidemiology of chronic kidney disease in children in Serbia

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Background.

The epidemiological information from well-defined populations regarding childhood chronic kidney disease (CKD), particularly those concerning non-terminal stages, are scanty. The epidemiology of CKD in children is often based on renal replacement therapy (RRT) data, which means that a considerable number of children in earlier stages of CKD are missed as they will reach end-stage renal disease (ESRD) in adulthood. Here, we report the basic epidemiological data on childhood CKD in Serbia, gathered over the 10-year period of activity of the Serbian Pediatric Registry of Chronic Kidney Disease.

Methods.

Since 2000–09, data on incidence, prevalence, aetiology, treatment modalities and outcome of children aged 0–18 years, with CKD Stages 2–4 and CKD Stage 5, were collected by reporting index cases from paediatric centres.

Results.

Three hundred and thirty-six children were registered (211 boys, 125 girls, male/female ratio 1.7). The median age at registration was 9.0 years [interquartile range (IQR) 3–13]. Median follow-up was 4.0 years (IQR, 1–9). The median glomerular filtration rate (GFR) at the time of the registration was 39.6 mL/min/1.73m2 (IQR, 13.8–65.4). Median annual incidence of CKD 2–5 stages was 14.3 per million age-related population (p.m.a.r.p.), while those of CKD 2–4 or CKD 5 were 9.1 and 5.7 p.m.a.r.p., respectively. The median prevalence of CKD 2–5 was 96.1 p.m.a.r.p., 52.8 p.m.a.r.p. in CKD 2–4 and 62.2 p.m.a.r.p. in CKD 5. The main causes of CKD were congenital anomalies of kidney and urinary tract and hereditary nephropathies. Kidney survival was the worst in children with glomerular diseases and in those with advanced CKD. Haemodialysis was the most common first modality of RRT. Mortality rate was 4.5%, mainly due to cardiovascular and infectious complications.

Conclusions.

Epidemiology of paediatric CKD in Serbia is similar to that reported from developed European countries. The knowledge of the epidemiology of earlier stages of CKD is essential for both institution of renoprotective therapy and planning of RRT, a fact of paramount importance in countries with limited resources.

Keywords: end-stage renal disease; epidemiology; non-terminal renal failure; renal replacement therapy

Journal Article.  3566 words.  Illustrated.

Subjects: Nephrology

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