The incidence of and risk factors for late presentation of childhood chronic kidney disease: A systematic review and meta-analysis

Plumb, Lucy; Boother, Emily J.; Caskey, Fergus; Sinha, Manish D.; Ben‐Shlomo, Yoav

doi:10.1371/journal.pone.0244709

Cited by 7 publications

(3 citation statements)

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“…But, in general late presentation is a global problem among children with chronic kidney disease, with higher incidence in low/middleincome countries. Children presenting late are older and more likely to have non-congenital kidney disease as in females (19).…”

Section: Discussionmentioning

confidence: 99%

Pattern of Renal and Urinary Tract Diseases Among Children Admitted to A General Ward Over One Year

Kotb

Yassin

Lotfi

et al. 2022

Pediatric Sciences Journal

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Background: Children with renal and urinary tract diseases may require admission in general pediatric wards. Aim of the work:To identify the pattern of renal and urinary tract diseases among children admitted to general pediatric ward and their associated morbidities and mortality. Methods: Retrospective analysis of files of children with confirmed diagnosis of renal and urinary tract diseases who were admitted to a general pediatric ward, at Children Hospital, Cairo University. Results: During 12 months, 142 patients with renal or urinary tract disease were admitted to our pediatric general ward. Of them 97 (68.3%) were boys and 45 (31.7%) were girls. Their mean age was 5.1 ± 3.89 years. Of them 121 (85.2%) had isolated renal disease and 21 (14.8%) had renal affection as a part of systemic diseases. The most common diseases among those with isolated renal disease, were glomerular diseases (62 patients, 51.2%), followed by congenital anomalies of the kidney and urinary tract (33 patients, 27.3%). Different types of infection were the main cause for admission among 78 (54.9%) children. Thirty four patients (23.9%) underwent renal replacement therapy, and 26 patients suffered from poor outcome. Conclusion:Pediatricians should have the knowledge of the different presentations of renal disease in children and be trained for timely referral to the pediatric nephrologists and/or urologist. Renal diseases should be suspected in those with diseases of other systems. Infections are the commonest renal indication of admission in the general pediatric ward.

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Section: Discussionmentioning

confidence: 99%

Pattern of Renal and Urinary Tract Diseases Among Children Admitted to A General Ward Over One Year

Kotb

Yassin

Lotfi

et al. 2022

Pediatric Sciences Journal

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show abstract

“…The lack of public and policymakers' awareness of pediatric kidney diseases and the consequences of delays in diagnosis and adequate treatment are major contributors to alarming situations. For example, the rate of late presentation of pediatric CKD, defined as first presentation to pediatric nephrology care with kidney failure, is unacceptably high (> 40%), especially in low-and middle-income countries, reflecting the lack of timely diagnosis and referral to pediatric kidney care [31]. Another situation of long-term concern is the association of a history of clinically evident CKD, albeit mild, in childhood with a higher risk of kidney failure at a young age in adulthood, which further highlights the demand for better prevention and treatment by pediatric nephrologists [32].…”

Section: Importance Of Awareness and Advocacy In Pediatric Ckdmentioning

confidence: 99%

What is the true burden of chronic kidney disease in children worldwide?

Harambat

Madden²

2022

Pediatr Nephrol

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“…In recent years, we have seen the atypical clinical picture of kidney disease in children, predominance of both chronic, latent forms, and manifest, aggressive, severe forms [2]. Doctors very often diagnose kidney diseases in children when they already develop irreversible changes and chronicity of the pathological process.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Different Types of Hypoxia on the Morpho-Functional State of the Kidneys of Fetuses and Newborns: The Results of Own Long-Term Experimental Studies: The Effect of Different Types of Hypoxia on the Morpho-Functional State of the Kidneys of Fetuses and Newborns

Myroshnychenko

2022

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Introduction. The vast majority of kidney diseases in children and adults have their origins in the antenatal, intranatal or postnatal periods of development. Poor health of women of childbearing potential, complications during pregnancy and delivery often lead to the development of various types of hypoxia (chronic intrauterine hypoxia (CIH), acute intranatal hypoxia, acute postnatal hypoxia (APH), mixed hypoxia (MH)). The latter are a common cause of fetal and neonatal disorders, leading to damage of various organs and systems, including the kidneys. The purpose is to highlight the main results of own long-term experimental studies aimed at determining the effect of different types of hypoxia (CIH, APH, MH) on the morpho-functional state of the kidneys in fetuses and newborns. Materials and methods. In this study, the author modelled alpine hypoxia using a sealed pressure chamber from which air was pumped out, creating conditions for a sharp decrease in atmospheric pressure. Every day, we placed mature female rats with an average weight of 220–250 g in conditions corresponding to 7,500 meters hight at 287 mm Hg for 20 minutes at the same time. During the experiment, we ranked the animals into four groups: group 1 – control group – pregnant female rats (n=3) that did not experience alpine hypoxia, some females were removed from the experiment in late gestation to remove fetuses (n=7). The offsprings (n=11) received from the rest of the females, were removed from the experiment on the first day after birth. Group 2 – a study group with simulation of CIH – pregnant female rats (n=4) throughout pregnancy (21 days) were subjected to daily alpine hypoxia, with some females removed from the experiment in late gestation to remove fetuses (n=6). Offsprings (n=10) from the rest of the females were removed from the experiment on the first days of life. Group 3 – a study group with modeling of APH – pregnant female rats (n=2) were not subjected to alpine hypoxia, but their offsprings (n=8) on the first day of life were subjected to alpine hypoxia once for 15 minutes, and then they were removed from the experiment. Group 4 – a study group for modeling MH – pregnant female rats (n=3) throughout pregnancy were subjected to daily alpine hypoxia, then the offsprings obtained from them (n=8) on the first day of life were subjected to alpine hypoxia once for 15 minutes and removed from the experiment. Histological, histochemical, immunohistochemical, morphometric and statistical research method were used. Results. Acute postnatal, chronic intrauterine and mixed hypoxia lead to the development of respectively minimal, moderate and pronounced morphological changes in the capsules, parenchymal and stromal-vascular components of the kidneys, primarily damaging the vessels of the stroma and parenchyma, where more pronounced changes occur in the tubules, collecting tubules, and in chronic intrauterine hypoxia these changes increase in newborns compared to fetuses. Experimental hypoxia causes the development of hemodynamic disorders, degenerative-desquamative changes of vascular endotheliocytes, epitheliocytes of Bowman's capsules, tubules, collecting tubules, and the latter in acute postnatal hypoxia are observed mainly in the proximal tubules, and in chronic intrauterine and mixed hypoxia in all parts of the tubular system and collecting tubules. Chronic intrauterine and mixed hypoxia promote cyst formation, delay the processes of glomerulogenesis and tubulogenesis. Acute postnatal, chronic intrauterine and mixed hypoxia stimulate fibroblastic cells in the kidneys, and chronic intrauterine and mixed hypoxia also induce epithelial-mesenchymal transformation, causing the development of sclerosis. Acute postnatal, chronic intrauterine and mixed hypoxia induce apoptosis, proliferation, leading to an imbalance between them due to the prevaling proliferation in acute postnatal and chronic intrauterine hypoxia and apoptosis in mixed hypoxia. Conclusions. Identified morphological changes in the kidneys of fetuses and newborns developed under the influence of acute postnatal, chronic intrauterine and mixed hypoxia, given the unity of structure and function, will lead to functional changes in these organs in subsequent postnatal ontogenesis in such children and the emergence of different nephrological pathology. This study actualizes the implementation of preventive measures among persons of reproductive age, dictates the need for quality pre-pregnancy training, which should be aimed at timely detection and treatment of genital and extragenital pathology in women. Keywords: acute postnatal hypoxia, chronic intrauterine hypoxia, fetus, kidneys, mixed hypoxia, morphology, newborn.

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The incidence of and risk factors for late presentation of childhood chronic kidney disease: A systematic review and meta-analysis

Cited by 7 publications

References 50 publications

Pattern of Renal and Urinary Tract Diseases Among Children Admitted to A General Ward Over One Year

Pattern of Renal and Urinary Tract Diseases Among Children Admitted to A General Ward Over One Year

What is the true burden of chronic kidney disease in children worldwide?

The Effect of Different Types of Hypoxia on the Morpho-Functional State of the Kidneys of Fetuses and Newborns: The Results of Own Long-Term Experimental Studies: The Effect of Different Types of Hypoxia on the Morpho-Functional State of the Kidneys of Fetuses and Newborns

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