Mitochondrial Disease in Children: The Nephrologist's Perspective.

Abstract

To review the importance of the kidney in MD from the nephrologist's perspective within the setting of a pediatric tertiary reference center. Retrospective study of children (<18years) with MD followed between 2000 and 2016 at a tertiary Spanish center. 52 patients were included. The mean age at the time of the study was 10years (SD±5.1). The mean follow-up time was 6.1years (SD±4.7). The median age at diagnosis was 2.5years (0.3-13.5).The median number of affected systems was two (range 1-6). The nervous system was the most affected system, with 51 patients (~98%) presenting with neurological involvement. 20 patients (~40%) presented with endocrinological manifestations, 18 (~35%) with vision problems, 16 (~30%) with gastrointestinal symptoms, 5 (~10%) patients developed hearing impairment, and 6 (~10%) cardiac disease.We detected renal involvement in 13 patients (25%). Eight patients had tubular disease, most frequently hypercalciuria with hypouricemia and five patients had glomerular involvement, with proteinuria and/or decreased glomerular filtration rate as the most frequent symptoms. Only 21 patients (~40%) had been seen by a pediatric nephrologist. Renal disease was a common occurrence in patients with mitochondrial disease, present in our study in 25% of patients. A regular screening of renal function parameters and the involvement of a nephrologist as part of the multidisciplinary approach to mitochondrial disease appears warranted.