Abstract
Background: The pattern of Pediatric kidney disease varies from
congenital anomalies of kidneys and urinary tract (CAKUT) such as
obstructive uropathies to acquired glomerulonephritides, urinary stone
disease and urinary tract infections (UTI).
Objectives: To determine the pattern of renal diseases in children in our
set up.
Methods: The children aged 1 month to 18 years with renal problems
presented at Pediatric Nephrology, National Institute of Child Health,
Karachi from March 2010 to March 2011 were included.
Results: Among 602 patients, 393 were male and 207 female. Mean
age+SD was 7.2+4.21 years. Common presentations were edema (56%),
anemia (38%), dysuria (37%), fever (36%) and burning micturition (34%).
Nephrotic syndrome (NS 49%), chronic kidney disease (CKD 29%) and
urinary stone disease (4%) were the most common diseases. Other
diseases were congenital obstructive uropathy (3.5%), acute kidney
injury (AKI 3%), acute glomerulonephritis (AGN 2%), hypoplasticdysplastic kidneys (2%), UTI, neurogenic bladder and vesicoureteral reflux
(VUR).
In 321 cases with GN, 290 had NS, 13 acute GN, 8 secondary GN and 3
had congenital NS. Among NS, 268 (90.52%) were presumed minimal
change disease (MCD) whereas 30 had steroid resistance, 14 had focal
segmental glomerulosclerosis, 6 membranoproliferative GN, 5 MCD; 2
each had membranous GN and IgM nephropathy. In 173 CKD patients,
renal hypoplasia-dysplasia (39.3%), urinary stones (25.6%) and posterior
urethral valves (PUV19%) were the most common causes. Other causes
were juvenile nephronophthiasis (10.4%), VUR (8.6%), neurogenic bladder
(7.5%) and cystic renal disease (5.2%). Of 186 with CAKUT, renal
hypoplasia–dysplasia was found in 43 %, PUV in 29% and VUR in 12.9%.
Conclusion: The current spectrum of renal diseases showed that most
common renal diseases are PNS, CKD and urinary stones.
