文本框: OUTCOME OF CHRONIC RENAL FAILURE IN KOREAN CHILDREN
Kim PK1, Kim K2 and Korean Society of Pediatric Nephrology
1 Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2 Department of Pediatrics, Konkuk University College of Medicine, Seoul, Korea
 
Objective: We analyzed the demographic data and the clinical course of Korean children with chronic renal failure observed between 1990 and 1999. 
Methods: Questionnaires were mailed throughout the country to children’s hospitals for clinical data on chronic renal failure (CRF), end-stage renal disease (ESRD), and mode & outcome of renal replacement therapy (RRT).
Results: 1) 401 children (254 boys, 147 girls) with CRF (Cr> 1.2 mg/dl for more than 3months or until death) were identified. 2) The overall incidence of CRF and ESRD under 16 years of age were 3.68 and 2.61/million child population, respectively. 3) Of these patients, 22% were under 5 years of age, 28% were 5 to 10 years and 50% were 10 to 15 years. 4) 85 % of patients were classified with an original underlying renal disease. Reflux nephropathy (16%) was the most common single cause of CRF. 5) 284 (70 % of all CRF) patients reached ESRD and 99.3% of them were started on RRT. 6) 118 cases of Hemodialysis (HD, 42%), 98 cases of peritoneal dialysis (PD, 35%), and 62 cases of renal transplantation (RT,23%) were performed as an initial mode of RRT. Among the 284 ESRD patients, 159 renal transplantation (46%) was performed. 7) 93.7% of all transplanted patients maintained normal renal function. 8) A total of 43 patients (10.7%) with CRF and 33 patients (11.6%) with ESRD died. The over all survival rate of RRT was 88.7% during the mean follow-up period of 37 months (HD 85.6%, PD 88.8%, RT 93.5%)
Conclusion: A major effort for the early diagnosis of reflux nephropathy and the identification of the original renal disease of CRF should be encouraged. Transplantation is now the main mode of RRT in Korean children with ESRD and has shown better outcome than other modes of RRT.
2P-S6-4