Etiologie en epidemiologie van terminale nierinsufficiëntie op de kinderleeftijd in Nederland in 1987-2001

To describe the incidence and causes of terminal renal insufficiency in childhood in the years 1987-2001, to compare these with the published data for 1979-1986, and to determine the differences, if any, between native Dutch and immigrant patients with regard to the underlying renal disease.

Design

Retrospective.

Method

Data were collected from all children (< 16 years of age) in the Netherlands who either started with haemodialysis (without recovery of renal function in the first 3 months) or underwent kidney transplantation before haemodialysis became necessary in the period from 1 January 1987 to 31 December 2001 because of terminal renal insufficiency.

Results

In 1987-2001, 351 children started with treatment designed to replace their renal function: 197 boys and 154 girls. The median incidence of terminal renal insufficiency was 5.8 per million children per year. The prevalence on 31 December 2001 was 38.7 per million children. The most frequent cause of terminal renal insufficiency was urethral valves, which occurred more often than in the period 1979-1986 (50/351 (14) versus 10/167 (6)). The percentage contribution of the various underlying diseases was not statistically significantly different for patients of Dutch (n = 271) and non-Dutch origin (n = 80). Focal segmental glomerulosclerosis was seen more often in children from South America than in children from the countries around the Mediterranean (8/28 (29) versus 1/33 (3)). In 314 children, the initial treatment was haemodialysis; peritoneal dialysis was given in 196 of these (62), compared to 43/167 (26) in 1979-1986. In 37 children, kidney transplantation was performed before the haemodialysis stage was reached. Among the total of 278 initial kidney transplants, 54 (19) involved a kidney from a living donor. The calculated 5-year survival of the transplants was 76 (living donor: 80; cadaver graft: 73). The calculated 10-year survival of the patients was 94.

Ned Tijdschr Geneeskd. 2006;150:1674-9