Chronic renal insufficiency in children and adolescents: the 1996 annual report of NAPRTCS

Abstract

The 1996 annual report of the Chronic Renal Insufficiency Arm of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) summarizes descriptive data and highlights important features on 1,725 patients from 130 centers. This database contains information on patients with an estimated glomerular filtration rate (GFR) < or = 75 ml/min per 1.73 m2 as calculated by the Schwartz formula, who were treated on or after 1 January 1994. Thus this report reflects 2 years of data entry. Analysis of the data revealed that nearly two-thirds of patients registered had a structural anomaly. On average, patients were 1.5 standard deviations below age- and sex-specific norms for height, and 0.6 standard deviations below weight norms. Mean serum creatinine for the entire group was 2.4 mg/dl and 68% of patients had a baseline GFR of at least 25 ml/min per 1.73 m2. The mean hematocrit for all children at registration was 33.3 +/- 6.3%, and did not vary among age groups. Overall, 30.9% of patients had a hematocrit < 30%. Only 12.8% of patients were receiving Epoetin therapy. Although still in infancy, the Chronic Renal Insufficiency Arm of the NAPRTCS database in providing important insights into this disorder.

Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m2

“…For example, the ItalKid Project, a prospective, population-based Italian study on CKD epidemiology [5], and the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) [6] both defined CKD as an GFR of <75 mL/min/1.73 m 2 . The Chronic Kidney Disease in Children (CKiD) prospective cohort study enrolled 586 children aged between 1 and 16 years with an eGFR ranging from 30 to 90 mL/min/1.73 m 2 [3], of whom 540 children had eGFR of <75 mL/min/1.73 m 2 [23].…”

“…The latter was defined as a glomerular filtration rate (GFR) of <75 mL/min/1.73 m 2 [4][5][6]. CKD was defined by the National Kidney Foundation/Kidney Disease and Outcome Quality Initiative (NKF/KDOQI) Group as any patient who has kidney damage lasting for at least 3 months with or without a decreased GFR or any patient who has a GFR of <60 mL/min/1.73 m 2 lasting for 3 months with or without kidney damage [7].…”

Epidemiology of Chronic Renal Failure in Children: Data From the ItalKid Project

“…Previous studies attempting to describe the epidemiology of renal insufficiency in children have provided mor- bidity figures but, as they were sometimes more like multicenter investigations than population-based registry studies 3 or concentrated on more severe degrees of renal insufficiency, 1,2 have offered an incomplete picture. These methodological differences alone may explain why the incidence rate estimated in our study (12.1 per marp) is higher than that reported in the few other areas of the world where it has been studied.…”

“…The existing studies concentrate on the late and more severe stages of renal impairment 1,2 or are not populationbased in nature, 3 and some methodologically welldesigned childhood CRF registries have the major limitation of being restricted to small reference populations. 4 -6 The lack of population-based information means that the epidemiology of childhood CRF is often based on renal replacement therapy data, 7 but the vast majority of children with renal impairment (particularly congenital abnormalities) reach ESRD when they are far beyond pediatric age and are therefore not included.…”

Nutritional Status in Children with Chronic Renal Failure on Hemodialysis

“…CKD is a major public health problem worldwide. Most of the existing data on the epidemiology of CKD during childhood concentrates on the late and more severe stages of renal impairment and are not population based in nature [1]. The incidence in of CKD in Europe was consistent, being around 11-12 per million of the agerelated population [2].…”