Objective The aim of this paper is to report our extraordinary experience with childhood CRF in Iraqi children.

Methods From January 1993 to July 2007, 80 patients with a diagnosis of chronic renal failure (CRF) were observed at the University Hospital in Al Kadhimiyia, Baghdad. Fifty one patients were males (63.75%) and 29 (36.25%) were females. The male-female ratio was 1.75, and the age at referral ranged from 2 months to 18 years (mean 9 years).

Results The single most common cause of CRF was chronic glomerulonephritis (19%). The largest etiological group was hereditary disorders and genetic syndrome (28.8%). Cystinosis was the most common hereditary disorder causing CRF. Oculo-cerebro-renal syndrome and severe variant of Hinman syndrome which are rare causes of CRF accounted for 10% of the patients. Most patients (93.6%) were treated by conservative measures with or without intermittent peritoneal dialysis (IPD). Five patients were treated with chronic hemodialysis. Only 2 patients received live related donor kidney transplants. In 14 (16.5%) patients acacia gum supplementation was added to the conservative measures and resulted in amelioration of the uremic symptoms and lowering of blood urea levels and delaying the need for dialysis. The longest survival of 6 years was achieved in 2 patients, both treated initially with IPD. One of the patients was transplanted and the other was treated with a combination of the traditional conservative measures and acacia gum supplementation.

Conclusion The pattern of childhood CRF in Iraq is unique and differs from previous reports.