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Pediatric kidney diseases in an African country: prevalence, spectrum and outcome
Taiwo A Ladapo1, Christopher I Esezobor, Foluso E Lesi
1Department of Pediatrics, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Insights
Pediatric kidney diseases, including nephrotic syndrome and acute kidney injury, are increasingly prevalent in Sub-Saharan Africa, leading to significant mortality. Early detection and improved healthcare access are crucial for better outcomes in children with renal conditions.
Area of Science:
- Pediatric Nephrology
- Public Health
- Resource-Constrained Settings
Background:
- Limited data complicates resource allocation for pediatric kidney diseases in resource-limited areas.
- Focus on communicable diseases often overshadows the care of children with renal conditions.
Purpose of the Study:
- To delineate the spectrum of pediatric nephrology diseases in a Sub-Saharan African tertiary hospital.
- To identify challenges in managing pediatric kidney diseases in this setting.
Main Methods:
- A 4-year retrospective review of pediatric renal admissions.
- Determination of overall and disease-specific prevalence and mortality rates.
- Comparison with nationwide pediatric kidney disease data.
Main Results:
- Kidney diseases represented 8.9% of pediatric admissions, with a prevalence of 22.3 per 1000 child-admissions annually.
- Nephrotic syndrome, acute kidney injury (AKI), and nephroblastoma comprised nearly 70% of admissions.
- Overall mortality was 14.4%, with AKI contributing 36%; chronic kidney disease also showed poor outcomes.
Conclusions:
- Pediatric renal disease is rising in the region, causing substantial morbidity and mortality.
- Late presentation and high treatment costs are major barriers to care.
- Recommendations include preventive nephrology, specialized training, and enhanced health insurance.
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.
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