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 ORIGINAL ARTICLE
Year : 2014  |  Volume : 24  |  Issue : 6  |  Page : 362-366

Clinical profile and outcome of renal tubular disorders in children: A single center experience


1 Department of Nephrology, King George Hospital/Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
2 Department of Paediatrics, NEIGRIHMS, Shillong, Meghalaya, India
3 Department of Paediatric Nephrology, St. John's Medical College Hospital, Bengaluru, Karnataka, India

Correspondence Address:
B Vijay Kiran
S1, Senior Resident Hostel, Andhra Medical College/King George Hospital, Vishakhapatnam, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.133002

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Tubular disorders form a significant proportion of pediatric kidney diseases and are an important differential diagnosis of failure to thrive (FTT) in children. Data regarding their outcome is scarce from India. We evaluated the clinical profile of these children and studied the outcome in terms of their growth and renal failure. This is a retrospective longitudinal study of all children with renal tubular disorders attending a tertiary care pediatric nephrology center from 2005 to 2010. Growth and renal outcomes were assessed by Z scores and estimated glomerular filtration rate at diagnosis and. The common disorders encountered were distal renal tubular acidosis (d-RTA) (44%), Bartter-like (Bartter's and Gitelman) syndromes (22%) followed by hereditary Fanconi syndrome (cystinosis and idiopathic Fanconi syndrome) (13%) and few cases of nephrogenic diabetes insipidus, hypophosphatemic rickets and idiopathic hypercalciuria. Male: female ratio was 1.22. The median age at diagnosis was 1.5 (range 0.13-11) years. Growth failure was the presenting feature in 86% of children followed by polyuria (60%) and bone deformities (47%). In 60% of children with hereditary Fanconi syndrome, nephropathic cystinosis was diagnosed, all of whom progressed to stage III chronic kidney disease (CKD) within 3.41 ± 1.42 years. With appropriate therapy, catch-up growth was noted in d-RTA and Bartter syndrome. Renal tubular disorders usually present with FTT. d-RTA is the most common etiology followed by Bartter-like syndrome. Renal function is preserved in all these disorders except for nephropathic cystinosis, who ultimately progressed to CKD. With appropriate and inexpensive therapy, these children do grow well.






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Indian Journal of Nephrology
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Online since 20th Sept '07