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Chronic kidney disease among children in Guatemala

Alejandro Cerón1, Meredith P Fort2, Chris M Morine1

  • 1Department of Anthropology, University of Denver, Denver, Colorado, United States of America, alejandro.ceronvaldes@du.edu.

Revista Panamericana De Salud Publica = Pan American Journal of Public Health
|February 26, 2015
PubMed

Insights

Pediatric chronic kidney disease (CKD) and end-stage renal disease (ESRD) in Guatemala show lower incidence and prevalence, possibly due to diagnostic access issues. Progression to ESRD is linked to delayed diagnosis and referral.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) affects children globally, with significant regional variations in prevalence and progression.
  • Understanding the epidemiology of pediatric CKD and end-stage renal disease (ESRD) is crucial for targeted healthcare interventions.

Purpose of the Study:

  • To describe the geographic distribution of pediatric CKD in Guatemala.
  • To estimate the incidence and prevalence of pediatric ESRD.
  • To determine the time to progress to ESRD and associated risk factors.

Main Methods:

  • Analysis of a pediatric nephrology center registry (2004-2013).
  • Calculation of annual incidence and prevalence rates for ESRD.
  • Spatial autocorrelation analysis (Moran's index) for geographic distribution.
  • Multivariate Cox regression to identify risk factors for ESRD progression.

Main Results:

  • Out of 1,545 pediatric patients, 432 had chronic renal failure (CRF).
  • Pediatric ESRD incidence and prevalence were 4.6 and 4.9 per million population, respectively.
  • Higher ESRD incidence was observed in the Pacific coast and Guatemala City.
  • The cause of CRF remained undetermined in 43% of cases.
  • Average time to ESRD progression was 21.9 months, influenced by older age, glomerulopathies, and advanced CKD stage at consultation.

Conclusions:

  • Guatemalan pediatric ESRD rates are lower than in other nations, suggesting potential underdiagnosis.
  • Higher incidence areas and a significant proportion of undetermined CRF causes align with regional patterns.
  • Progression to ESRD may be exacerbated by delayed patient referral and diagnosis.
Abstract

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