Chronic kidney disease in Syrian children: a single center experience.

Background: Chronic kidney disease (CKD) is a condition marked by permanent kidney damage, which can eventually advance to kidney failure. Our study aimed to identify CKD causes and investigate the risk factors for CKD progression in Syrian children.

Methods: A single-center observational cohort study was conducted at Children's University Hospital in Damascus, included all patients admitted to the department of pediatric nephrology (inpatient unit) from February 2022 to February 2023, with CKD stages 2-5.

Results: Our study included 100 patients, with a slight female predominance, and mean age of 4.73 years ± 3.7, ranging from 3 months to 14 years. CKD causes were congenital anomalies of the kidney and urinary tract (CAKUT) in 79%, hereditary nephropathies in 12%, and glomerular diseases in 9%. After one year of follow-up, 38% of them were stable on conservative management and 62% had kidney failure. Gender, age, and family history of CKD were not statistically significant factors in CKD progression. The progression rate to kidney failure was highest in glomerular diseases, with 100% for glomerulonephritis and 80% for steroid-resistant nephrotic syndrome, and the progression rate in kidney dysplasia patients was 78.1%. Proteinuria, metabolic acidosis, hyperparathyroidism, hypertension, anemia, and hyperphosphatemia were significantly associated with CKD progression.

Conclusions: In Syrian children, CAKUT are the leading cause of CKD. CKD progression is most rapid in glomerular diseases. Modifiable risk factors, especially hypertension and proteinuria, play a significant role in CKD progression, which highlights the importance of early detection and appropriate management of these factors.