Chronic kidney disease in children and adolescents in Brunei Darussalam
Shi Ying Tan1, Lin Naing1, Aye Han1
1Shi Ying Tan, Lin Naing, Universiti Brunei Darussalam, Brunei Darussalam BE 1410, Bandar Seri Begawan, Brunei.
Insights
Brunei has a high prevalence of pediatric chronic kidney disease (CKD), with glomerulonephritis being the most common cause. Non-glomerular diseases and female patients showed poorer growth outcomes.
Area of Science:
- Pediatric Nephrology
- Epidemiology
- Chronic Kidney Disease (CKD)
Background:
- Chronic kidney disease (CKD) in children presents unique challenges for growth and long-term health.
- Understanding the epidemiology of pediatric CKD is crucial for public health initiatives.
Purpose of the Study:
- To determine the epidemiology of pediatric chronic kidney disease (CKD) in Brunei.
- To identify factors influencing growth and disease progression in these patients.
Main Methods:
- A 10-year cross-sectional study (2004-2013) of all pediatric CKD patients (<18 years) in Brunei.
- Data collection included demographics, anthropometrics, diagnoses, laboratory results, and blood pressure from clinical records.
Main Results:
- High national prevalence (736 per million child population) and incidence (91 pcmp) of pediatric CKD.
- Glomerulonephritis was the leading cause (69%), followed by congenital abnormalities (20%).
- Significant association between non-glomerular diseases, adolescent, and female patients with poor growth.
Conclusions:
- Brunei exhibits a high prevalence of pediatric CKD, predominantly caused by glomerulonephritis.
- Early diagnosis is noted in congenital kidney diseases.
- Factors such as non-glomerular disease type and patient demographics impact growth in pediatric CKD.
Aim:
To determine epidemiology of Bruneian paediatric chronic kidney disease (CKD) patients and factors that affect growth and progression of disease.
Methods:
A cross-sectional study conducted on all children below 18 years old who were diagnosed with CKD over a ten year period (2004 to 2013). The reference population was all children (< 18 years old) suffering from CKD and attending the tertiary paediatric nephrology clinic in Brunei Darussalam. Demographic (current age, age of diagnosis, gender, ethnicity), anthropometric (weight and height), diagnosis, laboratory data (serum creatinine and haemoglobin, urinalysis) and blood pressure were extracted from the patients' clinical case notes and recorded using a data collection form.
Results:
The study revealed a high national prevalence [736 per million child population (pmcp)] and incidence (91 pcmp) of CKD. If CKD was defined at Stage 1, 2, 3, 4 or 5, the associated prevalence figures were 736, 132, 83, 50 and 33 pmcp. Glomerulonephritis accounted for 69% of all prevalent cases, followed by congenital abnormalities of kidney and urinary tract (20%) and tubulointerstitial diseases (8%). Minimal change disease being the most common histological diagnosis. The median age of diagnosis was 4.5 years, with congenital disease patients experiencing an earlier onset of diagnosis. A large proportion of patients were below the 5% percentile for height and weight. Non-glomerular diseases, adolescent and female patients were significantly associated with poor growth, but not glomerular filtration rate, age of diagnosis or steroid usage.
Conclusion:
Brunei has a high prevalence of chronic kidney disease in the paediatric population with glomerulonephritis being the most common disease.