Decreased Rate of CKD Stage V at Admission Among Children: A Single-Center Experience from the Western Part of Turkey

OBJECTIVE: Chronic kidney disease (CKD) is an important problem in children worldwide. Clinical outcomes of CKD could be improved with early referral. In this study, we aimed to emphasize changing clinical and laboratory features of stage III and advanced CKD in children in the last 15 years at our clinic. MATERIAL and METHODS: The medical data of pediatric patients who had estimated glomerular filtration rates (eGFRs) of ≤60ml/min/1.73m2 treated at our hospital from January 1995 to December 2011 were retrospectively reviewed. Data were evaluated in three separate observation periods; period 1: January1995 to December 1999, period 2: January 2000 to December 2005, period 3: January 2006 to December 2011. Statistical analysis was conducted using chi-square and t-tests as well as Pearson correlation analysis in SPSS 20.0. RESULTS: A total of 242 patients (107 females; mean age 8.56±4.74 years) were included in the study. The leading cause of CKD was urologic diseases (136 patients, 56.2%). Recognizing the CKD children in late stages decreased over time. The number of children diagnosed and managed in a pre-dialysis program significantly increased during period 3. The rate of patients who required urgent dialysis was greater in period 1 (76.5%) than in period 2 (46.1% ) and period 3 (27%),(p<0.05). CONCLUSION: Based on our results, the frequency of urological abnormalities did not change significantly overtime. On the other hand, the need for urgent dialysis significantly decreased over time.