All issues > Volume 30(9); 1987

Original Article

J Korean Pediatr Soc. 1987;30(9):990-1000. Published online September 30, 1987.

Clinical Evaluation of Kidney Diseases in Children.

Pyung Kil Kim¹, Ho Taek Kim¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Abstract

Disease pattern tends to change with improvements in the economic condition and social hygiene, and it is thought to be the same in renal disease. Yongdong Severance Hosptial is located in the Kang Nam area which is one of the most economically and socially developed areas. We assessed changes in the disease entity by reviewing clinical evaluations of renal diseases and by comparing this data with that of an earlier report. The clinical evaluations of renal disease patients who were admitted to the Yongdong Severance Hospital from Apr. 1983 to Feb. 1987 were reviewed. The results are as follows: 1) Four handred thirty seven renal disease patients were admitted to the pediatric department during this time, 5.3% of the total pediatric admissions. The male female ratio was 1.7: 1, and the mean age of the subjects was 7.7 years old. 2) The disease entities included APSGN were 23.3%: UTI, 22.3%: BRH, 19.5%: and nephrotic syndrome, 17.4%. Other minor diseases were HSP nephritis, 5.7%: hemorrhagic cystitis, 3.2%: hematuria of undetermined etiology 2.7%: acute renal failure, 2.5%: chronic renal failure, 1.1%: and Korean hemorrhagic fever and Alport syndrome were each present in one case respectively. 3) There were no statistical differences in annual incidences with the exception of a very small number of case of BRH in 1983, the year the hospital opened. 4) Seasonal incidences showed that more patients were admitted in the winter, and fewer in the summer. 5) Of the 180 patients who underwent renal biopsies, BRH was the most common diagnosis, 47.2%: followed by nephrotic syndrome, 31.1%. 6) The seasonal incidence of APSGN showed it to be common in November and least common in August. 7) In UTI, E. coli was the most prevalent organism isolated from urine cultures (38.1%). The radiologic studies revealed a V-U reflux in 26 cases (31.7%), a double collecting system in 12.2% and chronic pyelonephritis in 9.8%. 8) The mean age of BRH was 8.1 years of age and the most common age group was 6 〜9 years. Males were more predominent than females by a ratio of 1.4: 1. 9) 78.9% of nephrotic syndrome is classified as minimal change nephrotic syndrome (MCNS) and 33.3% of MCNS is diagnosed by clinical progression and laboratory data without renal biopsy. 10) The mean age of HSP nephritis was 7.2 years of age and symtoms had occurred before 6 years of age in 48% of the patients, and in males are more than females. 11) IgA nephropathy also occurred more often in males than females by a ratio of 1.3:1 and in 78.6% of the patients in the 6—12 year age group. 12) The total number of patients who suffered from hematuria was 259 cases and APSGN had the most common rate of incidence, 39.4%, and BRH, 32.8%. 13) 39 patients (8.9% of the subjects) were admitted at our hospital more than one time, and patients with nephrotic syndrome were the most commonly re-admitted patients (66.7%).

Keywords :Renal diseases in children