[Prevalence of Allergic Diseases in Children With Secondary Renal Tubular Acidosis Attending a Tertiary Care Pediatric Center]

Rev Alerg Mex. Apr-Jun 2017;64(2):133-141. doi: 10.29262/ram.v64i2.226.
[Article in Spanish]

Abstract

Background: It has been suggested a high prevalence of allergic disease in children with RTA.

Objective: To describe the prevalence of allergic diseases in children with secondary RTA (renal tubular acidosis) in the nephrology department of the National Institute of Pediatrics (NIP), México.

Methods: An observational, prospective, cross-sectional, descriptive study. Children with secondary RTA < 18 years who attended the outpatient nephrology service in the NIP for 24 months, were included. ISAAC questionnaire and the EAACI guidelines were applied. To prove a suspected allergy, skin tests, total and specific IgE, patch testing and food challenge were performed. Using SPSS 19, frequency of allergic diseases was described.

Results: 113 patients were included. Age 8 to 168 months. Male: 53.9 %. RTA types: Distal (64.6 %), proximal (26.5 %), mixed (1.8 %) and undetermined (7 %). Age of onset between 1 and 96 months. Serum bicarbonate 10.1 to 20 mEq/L. Allergic diseases were found in 24.8 %: allergic rhinitis (18.4 %), food allergy (9.7 %), atopic dermatitis (8 %), asthma (8 %) and allergic conjunctivitis (6.1 %). Total IgE was increased in 9 patients. Positive skin tests in 14.2 %. Positive chemiluminescence in 18 children; positive open food challenge in 11 children and patch tests in 4.

Conclusion: Secondary RTA is common in children attending tertiary care hospitals. The prevalence of allergic disease in children with secondary ATR, is similar to that described in the general population.

Antecedentes: Se ha sugerido elevada prevalencia de enfermedades alérgicas en niños con acidosis tubular renal. Objetivos: Describir la prevalencia de enfermedades alérgicas en niños con acidosis tubular renal secundaria atendidos en el Servicio de Nefrología del Instituto Nacional de Pediatría, México. Métodos: Estudio observacional, prospectivo, transversal, descriptivo. Se incluyeron niños atendidos durante 24 meses. Se aplicó el cuestionario ISAAC y los criterios de la guía EAACI. Ante sospecha de alergia se realizaron pruebas cutáneas, IgE total y específica, pruebas del parche y reto alimentario. Resultados: Se incluyeron 113 pacientes con edades entre 8 y 168 meses; 53.9 % del sexo masculino. Tipos de acidosis tubular renal: distal (64.6 %), proximal (26.5 %), mixta (1.8 %) y no determinada (7 %). La edad de inicio osciló entre 1 y 96 meses. Se registró 10.1 a 20 mEq/L de bicarbonato sérico; 24.8 % mostró enfermedades alérgicas: 18.4 % rinitis alérgica, 9.7 % alergia alimentaria, 8 % dermatitis atópica, 8 % asma y 6.1 % conjuntivitis alérgica. Se observó IgE total elevada en 9 pacientes. En 14.2 % las pruebas cutáneas fueron positivas y la quimioluminiscencia en 18 niños; el reto abierto con alimentos fue positivo en 11 y las pruebas del parche en 4. Conclusiones: La prevalencia de enfermedades alérgicas en niños con acidosis tubular renal secundaria fue similar a la de la población general.

Keywords: Allergic diseases; Children; Secondary renal tubular acidosis; Serum bicarbonate.

Publication types

  • Observational Study

MeSH terms

  • Acidosis, Renal Tubular / blood
  • Acidosis, Renal Tubular / epidemiology*
  • Acidosis, Renal Tubular / etiology
  • Adolescent
  • Bicarbonates / blood
  • Child, Preschool
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / epidemiology
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Hypersensitivity / blood
  • Hypersensitivity / diagnosis
  • Hypersensitivity / epidemiology*
  • Immunoglobulin E / blood
  • Infant
  • Male
  • Mexico / epidemiology
  • Prevalence
  • Prospective Studies
  • Skin Tests
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Bicarbonates
  • Immunoglobulin E