Chronic Kidney Disease in Southwestern Iranian Children.

Objective: The aim of the study was to determine the etiology of Chronic Kidney Disease (CKD) among children attending the pediatric nephrology service at Abuzar children s hospital in Ahvaz city, the referral center in Southwest of Iran. Methods: We reviewed the records of 139 children, diagnosed to have CKD over a 10-year period. CKD was defined a glomerular filtration rate (GFR) below 60 ml/1.73 m2/min persisting for more than 3 months. Findings: Among 139 children 81 (58%) were males. The mean age at diagnosis of CKD in the patients was 4.2 (±3.6) years. Mean level of serum creatinine at presentation was 1.9 (±1.4) mg/dl. The mean GFR at presentation was 33.5 (±15.4) ml/1.73m2/min while 22% of the patients were already at end stage renal failure indicating that these children were referred too late. Congenital urologic malformation was the commonest cause of CKD present in 70 (50.4%) children [reflux nephropathy (23.1%), hypo/dysplastic kidney (15.8%), obstructive uropathy (10.8%), and prune belly syndrome (0.7%)]. Other causes included hereditary nephropathies (17.2%), chronic glomerulo-nephritis (6.5%), multisystemic diseases (4.3%), miscellaneous and unknown (each one 10.8%). The mean duration of follow-up was 26 (±24.67) months. Peritoneal or hemodialysis was performed in 10 patients. Six patients underwent (4 live-related and 2 non-related) renal transplantation. The rest have died or received standard conservative management for CKD. Conclusion: The commonest causes of CKD were reflux nephropathy, hypo/dysplastic kidney, hereditary nephropathy and obstructive uropathy. Patients presented late, had severe CKD and were malnourished and stunted.