Early prognostic factors of infants with chronic renal failure caused by renal dysplasia

Renal dysplasia (RD) is a common cause of chronic renal failure (CRF) in ch ildren. The evolution towards end-stage renal failure is unpredictable due to the paucity of early prognostic factors. In order to identify early prog nostic clinical criteria, we have retrospectively analyzed renal function a nd growth in 11 infants with RD and CRF from birth up to 4 years of age. Ch ildren with obstructive RD were not included. Glomerular filtration rate (G FR) was estimated from Schwartz formula. In infants with a GFR below 15 ml/ min per 1.73 m(2) at 6 months of age (group A, n=5), kidney function did no t further improve; 4 reached end-stage renal failure between 8 months and 6 years of age. In contrast, infants with a GFR above 15 ml/min per 1.73 m(2 ) at 6 months of age (group B, n=6) experienced a significant improvement i n renal function during follow-up, and none required renal replacement ther apy. During the first 3 months of life all infants with RD and CRF develope d severe growth retardation. Between 6 months and 3 years of age, children from group B grew significantly better than those from group A. In conclusi on, our experience suggests that GFR, estimated from Schwartz formula at 6 months of age, is a useful prognostic factor in infants with RD and CRE Inf ants with a GFR below 15 ml/min per 1.73 m(2) are at risk of severe growth delay and the need for early renal replacement therapy, whereas those with a GFR above 15 ml/min per 1.73 m(2) have a relatively favorable long-term p rognosis.