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Journal of the Korean Society of Pediatric Nephrology 2000;4(2): 92-101.
소아 만성 신부전증의 전국적인 조사연구
김교순, 전정식, 이익준, 고대균, 이경일, 윤희상, 구자훈, 고철우, 조병수, 김준식, 손창성, 유기환, 안영호
2가톨릭의대 강남성모병원
3가톨릭의대 의정부성모병원
4가톨릭의대 성빈센트병원
5가톨릭의대 대전성모병원
11고려의대 안암병원
12고려의대 구로병원
Chronic Renal Failure in Children: A Nationwide Survey in Korea
KyoSun Kim, Jeong-Sik Jeon, Ik-Jun Lee, Dae-Gyun Go, Gyeong-Il Lee, Hui-Sang Yun, Ja-Hun Gu, Cheol-U Go, Byeong-Su Jo, Jun-Sik Kim, Chang-Seong Son, Gi-Hwan Yu, Yeong-Ho An
1The Korean Society of Pediatric Nephrology, Dept. of Pediatrics, Konkuk University College of Medicine
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Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999.
Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT).
Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$%$ on younger than 5 years, 28$%$ 5 to 10 years and 50$%$ 10 to 15 year. Eight five $%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$%$), followed by chronic pyelonephritis (21$%$), renal hrpo/dylplasia (9$%$), and hereditary nephropathies (7$%$). Reflux nephropathy (16$%$) was the most common single cause of CRF. ESRD was reached in 70$%$ of all patient. 99.3$%$ of these started RRT. Hemodialysis (HD, 42$%$), peritoneal dialysis (PD, 35$%$) and transplantation (TP, 23$%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.
Key words: chronic renal failure | end-stage renal disease | children | renal replacement therapy
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