All issues > Volume 31(6); 1988

Original Article

J Korean Pediatr Soc. 1988;31(6):738-746. Published online June 30, 1988.

Chronic Renal Failure in Children.

Kyung Ok Lee¹, Young Ho Ahn¹, Sang Bum Lee¹, Ja Hoon Koo¹

¹Department of Pediatrics, School of Medicine Kyungpook National University, Taegu, Korea

Received: November 12, 1987;  Accepted: January 6, 1988.

Abstract

Present study was undertaken to see the various clinicopathologic findings and outcome on 18 children with chronic renal failure, who had been admitted to the Pediatric department of Kyungpook National University Hospital from 1978 to 1986. And the following results were obtained. Male to female ratio was 5 to 4 and in 15 out of 18 cases, renal failure developed after 5 years of age. The common underlying diseases causing chronic renal failrue were; primary nephrotic syndrome in 3, lupus nephritis in 2, allergic purpura nephritis in 2 and in 9 cases, no causes could be found by clinical data nor by biopsy findings. Duration from onset of illness to the first admission was 6 months in about half of the cases. However, it was over 12 months in 38.8% of cases. On the first admission, edema was noted in 88.8%, oliguria in 66.7%, hypertension in 61%, proteinuria in 94.4% and the degree of proteinuria was over 1 gm/m²/day in the majority of cases. Anemia was noted in 78% and it was below 7 gm% in 16.8%. Elevation of serum BUN and creatinine was seen in 72% and 61% respectively and in half of the cases, BUN was over 50 mg%. Serum protein was below 6.0 gm% in 66.7% and serum cholesterol was over 200 mg% in 44.5%. HBsAg was positive in 20%. Among concomittant or complicating illnesses, those of cardiovascular system were the most common ones; hypertension was seen in 13 cases, and hypertensive encephalopathy, intracranial hemmorrhages and congestive heart failure were seen occasionally. Other complication illnesses were various infectious diseases, hypocalcemia (12 cases), hyponatrmia, hypokalemia, hyperkalemia and others. In out of 18 cases, 12 progressed to the end-stage renal failure, and the mean duration from onset of renal failure to the development of end-stage renal failure was 2.1 years. Outcome of the patients showed death in 5, conservative dietary & drug therapy in 5, continuous ambulatory peritoneal dialysis in 3 and renal transplantation in 2 cases. The causes of death were congestive heart failure in 1, sepsis in 1, hypertensive encephalopathy in 2 and hyperkalemia induced by erronous administration of KC1 tablet by parents in 1 case.

Keywords :Chronic Renal failure