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Hemodialysis in children: eleven years in a single center in Egypt
Doaa Mohammed Youssef1, Mayy Abd Alfattah Neemat-Allah
1Department of Pediatrics, Nephrology Unit, Zagazig University, Zagazig, Egypt. dody5176@yahoo.com.
Insights
Pediatric end-stage renal disease (ESRD) patients on hemodialysis in Egypt face significant challenges, with high mortality rates and frequent complications. Limited access to transplantation and resources impacts long-term outcomes for these children.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Public Health in Developing Nations
Background:
- End-stage renal disease (ESRD) significantly impacts children's health globally.
- Hemodialysis is a critical but challenging treatment for pediatric ESRD.
- Egypt faces unique healthcare challenges in managing chronic pediatric diseases.
Purpose of the Study:
- To describe the clinical profile of children with ESRD undergoing hemodialysis in Egypt.
- To evaluate the outcomes and complications in this pediatric population.
- To identify factors contributing to poor outcomes in a developing country context.
Main Methods:
- Retrospective chart review of 90 pediatric ESRD patients.
- Data collected over an 11-year period (January 2001 - January 2012).
- Analysis of causes of ESRD, hospital admissions, and mortality.
Main Results:
- Mean age at hemodialysis initiation was 5.6 years.
- Glomerular diseases, unknown etiology, and urological issues were primary ESRD causes.
- High mortality (26.7%) with common causes including heart failure and sepsis; low transplant rates (3%).
Conclusions:
- Managing pediatric ESRD in developing countries is hindered by late referrals and resource limitations.
- Prolonged hemodialysis treatment increases complication risks for children.
- Improved access to transplantation and better resource allocation are crucial for better pediatric ESRD outcomes.
Introduction:
The objective of this study was to report the clinical characteristics and outcomes of children with end-stage renal disease under regular hemodialysis in a dialysis unit in Egypt.
Materials And Methods:
Ninety children with end-stage renal disease were included in this study and their charts over the past 11 years (from January 2001 to January 2012) were reviewed.
Results:
The mean age of the patients at the start of hemodialysis was 5.6 +/- 1.4 years. The main causes of end-stage renal disease were glomerular diseases (35.6%), unknown etiology (33.3%), and urological problems (17.8%). Hospital admissions were due to hypertensive attacks, cardiac problems, arteriovenous shunt complications, and infections. Only 3 children received a kidney transplant and 24 (26.7%) died during the 11-year follow-up. Eight patients died of heart failure, 5 due to sepsis, and 4 due to unexplained causes.
Conclusions:
Maintaining an appropriate care for children with end-stage renal disease is quite difficult in developing countries due to factors such as late referral, poor medical service utilization, limitation of financial resources, and limitations to transplantation. As a result, maintaining on hemodialysis for long periods imposes a high risk of complications.
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