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Chronic renal insufficiency in children: The 2001 Annual Report of the NAPRTCS

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Abstract

End-stage renal disease (ESRD) is a major cause of morbidity in children. Besides its high cost to society, ESRD carries significant mortality. Chronic renal insufficiency (CRI) often precedes ESRD. Identifying factors that correlate with the rate of progression to ESRD is beneficial in the management of children with CRI. Since 1994 the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) has extended its registry to include children with CRI, defined as creatinine clearance (C Cr) <75 ml/min per 1.73 m2. As of January 2001, our database registered 4,666 children (<20 years of age) with CRI. Data analysis showed that at least 40% of patients entered had congenital urological anomalies; 39% of patients were followed for at least 3 years. Follow-up data showed that 31% of all registered patients progressed to ESRD by the end of the reporting period. There was a correlation between CRI and several co-morbid clinical factors: low hematocrit, hypoalbuminemia, hypocalcemia, hyperphosphatemia, and hyperparathyroidism, and the rate of progression to ESRD. Primary clinical diagnosis and the age at entry into registry were additional factors that correlated with the rate of progression to ESRD. The main cause of hospitalization in this registry was infection, which accounted for 45% of hospital admissions. Growth delay measured by standard deviation score at baseline was –1.40 at the time of registration. Our data suggest potential areas of improved care that could impact the onset of ESRD.

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Southwestern Medical Center, Texas, USA

    Mouin G. Seikaly

  2. The EMMES Coorporation, USA

    P. L. Ho

  3. New York Medical College, New York, USA

    Lea Emmett & Amir Tejani

  4. State University of New York at Stony Brook, New York, USA

    Richard N. Fine

  5. NAPRTCS, 19 Bradhurst Avenue, Box 10, Hawthorne, NY 10532–2140, USA

    Mouin G. Seikaly

Authors
  1. Mouin G. Seikaly
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  2. P. L. Ho
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  3. Lea Emmett
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  4. Richard N. Fine
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  5. Amir Tejani
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Correspondence to Mouin G. Seikaly.

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A. Tejani is deceased.

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Seikaly, M.G., Ho, P.L., Emmett, L. et al. Chronic renal insufficiency in children: The 2001 Annual Report of the NAPRTCS. Pediatr Nephrol 18, 796–804 (2003). https://doi.org/10.1007/s00467-003-1158-5

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  • DOI: https://doi.org/10.1007/s00467-003-1158-5

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