The most common causes of end-stage renal disease (ESRD) in children are congenital, cystic, and hereditary diseases, which combined account for 38% of incident cases. The most common disorders in this category are congenital obstructive uropathies (9.5%) and renal hypoplasia/dysplasia (10%). Primary glomerular disease is the second-most common etiology accounting for 25% of new cases, predominantly due to focal segmental glomerulosclerosis (FSGS). Secondary glomerulonephritis and vasculitis account for 12% of new cases, of which lupus nephritis is the most common. The underlying etiology of ESRD also varies by age of presentation. As expected, congenital/hereditary/cystic disorders are the most common underlying cause of ESRD amongst the youngest age groups, while primary and secondary glomerular diseases are the leading cause among adolescents.

Kidney transplantation is the preferred treatment for ESRD in children and confers improved survival, skeletal growth, heath-related quality of life, and neuropsychological development compared to dialysis.

Transplantation is initially considered when renal replacement therapy is imminent. Due to increased risk of graft loss and mortality in very young children, most pediatric centers perform kidney transplantation once children achieve a weight above 10–15 kg, which is typically around the age of 2 years. The underlying etiology for kidney failure, the rapidity of decline in kidney function, and the age and size of the patient determine whether an individual can receive a pre-emptive kidney transplant without preceding dialysis, which may provide a graft survival advantage. On average, 30% of pediatric kidney transplant recipients in the U.S. receive pre-emptive transplant, and an additional 24% receive dialysis treatment for less than 1 year prior to transplant.

The post Outcome of pediatric renal transplantation appeared first on Ay Health Medical Services Company.

THE INCIDENCE of chronic renal failure (CRF) in children is unknown, but current data suggest that 1.5
to 3 children per million develop end-stage renal disease (ESRD) each year.

The prevalence of CRF in the pediatric population worldwide is approximately 18 per million.

It has been reported that approximately 8% of adults on dialysis and 20% to 30% of children on dialysis have
abnormal urinary tracts.1 The registry of the North America Pediatric Renal Transplantation society confirms that different forms of obstructive uropathy (including reflux and dysplasia)

were not significantly different with regard to mean donor and recipient ages, and sex distribution. We also divided our patients
into two groups (before versus after 1996,) seeking to match patients by immunosuppressive drugs and year of transplantation.

Rejection was clinically diagnosed when a patient exhibitedtenderness over the graft site, swelling of the graft on ultrasonography, persistent fever, oliguria, hypertension, and progressive elevation of serum creati nine.

Biopsy was performed in cases of suspected rejection; the diagnosis was confirmed by increased
mesengial matrix, increased lobularity, decreased glomerular size and hyalinization, and vascular and tubular lesions. Children
returned to chronic dialysis, those who required retransplantation, and those who died of renal complications were all considered to have lost their grafts.

The post CRF in children appeared first on Ay Health Medical Services Company.