Epidemiology of Chronic Renal Insufficiency in Children in Slovakia

Overview

At the present time there is no available data on prevalence and incidence of chronic renal insufficiency (CHRI)in children in Slovakia. The last and the only study so far was that performed in 1975. In the present paper theauthors analyze the results of epidemiological investigation of the occurrence of CHRI in children in Slovakia in2002, which were the basis for the foundation of National Registry.The occurrence of CHRI in Slovakia in children up to 18 years of age is 18.2/1 million children. The prevalencein children up to 18 years, treated with active therapy substituting the function of the kidneys (dialysis andtransplantation) in 7.4/1 million population and 29.3/1 million children. CHRI is most frequently caused bycongenital anomalies of the kidneys and urinary tract (36%), tubulointerstitial nephritis constituted 17.1% andchronic glomerulonephritis only 10.47%, the number being significantly less than in 1977 (36%, p < 0.01). Thegreatest change over the last 30 years developed in the group of children with therapy substituting function of thekidneys. At the present time there are 24 children up to 15 years of age who undergo dialysis and 16 children aftersuccessful TX of the kidney. The proportion of hemodialysis and CCPD is 54 and 46%, respectively. The growthretardation affected 35% of patients and 51% of children in the terminal stage is treated with recombinanterythropoietin.The results of the epidemiological survey indicate a significant increase of CHRI in children in Slovakia since1977 (7.4 and 4.32 children/1 million population, respectively and 29.3 and 15.87/1 million children up to 15 yearsof age, respectively, p < 0.01). In comparison with advanced countries of Europe and the U.S.A., there are lowerproportions of patients with dialysis and children after kidney transplantation. The introduction of modernimmunosuppressive drugs and standard protocols into the therapy of glomerulonephritis contributed to improvementof the long-term prognosis. The possibilities of therapy substituting kidney function significantly prolongedsurvival and improved quality of life in children with chronic kidney failure.

Key words:
chronic renal insufficiency, prevalence, epidemiology, dialysis, transplantation