Farkhanda Hafeez, Mohammad Yaqoob, Iqbal Bano, Sajid Maqbool.
Chronic Renal Failure in Children.
J Coll Physicians Surg Pak Jan ;12(3):154-6.

Objective: To assess the clinical presentation, underlying causes and outcome of patients with chronic renal failure (CRF). Design: Prospective study. Place and Duration of Study: Nephrology Department, The Children s Hospital, Lahore, from January to December 2000. Patients and Methods: Patients of either sex under the age of sixteen years, with signs and symptoms suggestive of CRF and GFR < 75ml/min/1.73m2, were included. In addition to clinical evaluation they were investigated to find out the underline causes. Renal replacement therapy was provided to the patients with end stage renal disease (ESRD), and patients with CRF and renal insufficiency were treated conservatively. Results: Forty-two patients (13 %) of the total admission of Nephrology Department fulfilled the criteria with male to female ratio of 2.8: 1; the age range was 5 months to 16 years and majority (66.6%) presented after the age of five years. The most common clinical presentations were growth failure, hypertension and metabolic acidosis (50% each), pallor (34%) and oedema (26%). Congenital structural diseases were the most common (26%) followed by renal calculi (12%), reflux nephropathy and glomerular diseases (9.5% each), nephrocalcinosis (7.2%), neurogenic bladder and inherited diseases (4.7% each), focal segmental glomerulosclerosis (2.4%). No cause could be determined in 21 % of the patients. 64.2% of the patients were on regular follow-up, 21.4% expired, while 14.2% lost to follow-up. Conclusion: Children with growth failure, unexplained pallor and hypertension should be investigated for CRF. Early detection and timely management of treatable causes can prevent grave consequences.

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