Chronic Kidney Disease in Iran: First Report of the National Registry in Children and Adolescences

Abstract

Purpose: Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran. Materials and Methods: This cross-sectional study was conducted during 1991 - 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset. Results: A total of 1247 children were registered. The mean age of the children at registration was 0.69 +/- 4.72 years (range, 0.25 -18 years), 7.79 +/- 3.18 years for hemodialysis (HD), 4.24 +/- 1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4 +/- 1.95 years for the children who underwent the renal transplantation (RT) (P <.001). The mean year of follow-up was 7.19 +/- 4.65 years. The mean annual incidence of CKD 2-5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2-5 stages was 21.95 (pmarp). The cumulative 1-, 5-, and 10-year patients' survival rates were 98.3, 90.7, and 84.8, respectively. The etiology of the CKD included the congenital anomalies of the kidney and urinary tract (CAKUT) (40.01), glomerulopathy (19.00), unknown cause (18.28), and cystic/hereditary/congenital disease (11.14). Conclusion: The incidence and prevalence rate of pediatric CKD in Iran is relatively lower than those reported in Europe and other similar studies. CAKUT was the main cause of the CKD. Appropriate management of CAKUT including early urological intervention is required to preserve the renal function. Herein, the long-term survival rate was higher among the children with CKD than the literature.