[Epidemiology of chronic kidney disease in Spanish pediatric population. REPIR II Project].

Nefrologia

Sección de Nefrología Pediátrica, Hospital Donostia, San Sebastián, Guipúzcoa.

Published: November 2010

Objective: A national registry of children with Chronic Kidney Disease (CKD) was started in 2007. We analize it to know the incidence, prevalence, demography, etiology, clinical and metabolic state of the children with CKD, in stages 2-5 pre-dialysis, and complying with the K/DOQI guidelines.

Material And Methods: In the REPIR II 46 centers distributed throughout the Spanish geography are involved. To classify and evaluate comorbidity of the disease, the Clinical Practice Guidelines K/DOQI criteria are used. Each center provides an annual developmental data of each patient which is recorded in a On-line database.

Inclusion Criteria: patients with CKD who are between stage 2 and 5 in predialysis and which are 18 years old or less.

Results: In 2008 there were 605 patients with CKD, the incidence was 8.66 per million of pediatric population (pmpp) and the prevalence was 71.06 pmpp. Structural anomalies was the primary cause of CKD (59% of the cases). The percentage of glomerular diseases was very low (3%). There was a clear predominance of males (66%) and Caucasian race (88%). Mean GFR was 52 ± 2 ml/min/1.73 m(2) with 82% of them in stage 2 and 3. The prevalence of anaemia was 30%. Only 19% of our patients had hypertension and only 17% of them fulfilled the 4 recommendations for calcium-phosphorus metabolism of K/DOQI Guidelines. Mean height Z-Score was -1.03 ± 2. There were 136 patients (25%) who had a mean height Z-Score of size < or = -1.88. In a multivariate logistic regression analysis only a meaningful relationship between age and height was identified. All the children under 2 years old had a 40% higher probability of having a short height (OR = 1.40; P < 0.01). The percentage of malnutrition (BMI Z-Score < or = 1.88) was 7%, mostly in the 0-2 years old group.

Conclusions: We report the first study that performs a prospective analysis of incidence, prevalence, etiology and comorbidity of CKD in the pediatric population of the Spanish State. Given the short life of this record the data presented is provisional and may suffer meaningful changes in coming years.

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http://dx.doi.org/10.3265/Nefrologia.pre2010.May.10402DOI Listing

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