Pediatric kidney diseases in an African country: Prevalence, spectrum and outcome

Abstract

Insufficient data to guide the authorities responsible for resource allocation and a focus on communicable diseases increase the challenges of care of children with kidney disease in resource-constrained settings like ours. This study was performed with the aim to describe the current spectrum of pediatric nephrology disease in a tertiary hospital in Sub-Saharan Africa and highlight the challenges encountered in their care. A 4-year retrospective review of pediatric renal admissions was carried out and the overall prevalence, disease-specific prevalence and mortality rates were determined. Results were compared with nationwide data. Kidney diseases accounted for 8.9% of pediatric admissions with a prevalence of 22.3 admissions per 1000 child-admissions per year. Nephrotic syndrome, acute kidney injury and nephroblastoma accounted for almost 70% of admissions. The overall mortality was 14.4% with acute kidney injury accounting for 36% of this. Chronic kidney disease was also associated with poor outcome. The spectrum of disease nationwide is similar with a wide variation in disease-specific prevalence between geographic regions. The prevalence of genetic and hereditary conditions was low. The prevalence of pediatric renal disease in our environment is on the increase and associated with significant morbidity and mortality. Late presentation and high treatment costs were limitations to care. Preventive nephrology, training of pediatric nephrologists and strengthening of health insurance schemes are advocated.

Childhood kidney disease in developing countries: Is it a forgotten disease?

“…This is particularly pertinent in Africa, where the focus is on communicable diseases with lack of proper documentation and renal registries. [2] As a result there are insufficient data to guide the authorities responsible for resource allocation. This increases the challenges of providing care for children with kidney disease in a resource-limited environment.…”

Spectrum of Kidney and Urinary Tract Diseases in Kashmiri Children.

“…In previous reports, it varied ranging from 1.1-4.5% 25,26 . This may be indicative of poor disease characterization, consequent upon relative under-development of the sub-specialty in the state of Jammu and Kashmir.…”

Proteinuric kidney disease in children at Queen Elizabeth Central Hospital, Malawi

“…Renal registries are generally unavailable in developing countries [4]. However, studies done in Africa, Asia, Middle East and South American developing countries all show similar findings [5–7] where in contrast to high income settings, glomerular disease is the predominant cause of paediatric kidney disease.. There is a high prevalence of infectious diseases in developing countries which is a risk factor for glomerular kidney disease [6–9].…”