Chronic Renal Failure in Thai Children : Etiology, Cost, and Outcome
ACHRA SUMBOONNANONDA, M.D.*, PORNCHAI KINGWATANAKUL,M.D.***, PRAPAIPIM THIRAKHUPT, M.D.**, ARUN VONGJIRAD, M.D.*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok 10700, * * Department of Pediatrics, Phramongkutklao College of Medicine, Bangkok 10400, *** Department of Pediatrics, King Chulalongkom Memorial Hospital, Bangkok I 0330, Thailand.
We studied the epidemiology, cost and outcome of chronic renal failure (CRF) in Thai
children by sending questionnaires to all university hospitals, all government general service
hospitals and all pediatric nephrologists in the country. A total of 238 cases (I 07 from 8 university
hospitals and 131 from 70 government general service hospitals) were diagnosed from 1996 to
1998. Mean age of the patients was 8.3 ± 4.9 yr, male to female ratio was 1.4: I. Congenital
KUB anomalies (obstructive uropathy and hypo/dysplasia) were the main causes of CRF in
these patients, especially in the under five age group. Only a small number of patients received
renal replacement therapy (chronic dialysis and kidney transplant) and the mortality rate was 18.7
per cent in university hospitals. Renal transplantation was performed in only 5 patients in 2 pediatric
units and another 2 patients in adult renal units. The outcome of renal transplantation in this small
group of patients was very satisfactory. The cost of CRF treatment in children was comparable
to adults. The main problems in the management of CRF in Thai children included the lack of
experienced personnel, lack of equipment and funding.
We conclude that in order to improve the care of CRF in Thai children, a training program
for health personnel and budget allocation should be established.
Keywords : Chronic Renal Failure, Chronic Dialysis, Kidney Transplant
