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Burden of Paediatric Kidney Diseases in a Tertiary Care Hospital in Harare, Zimbabwe
P D Makanda-Charambira1, H A Mujuru1, I Ticklay1
1Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Insights
Childhood kidney diseases are a significant cause of hospitalizations, with acute kidney injury and nephrotic syndrome being most common. Limited resources hinder treatment, leading to high mortality, especially in end-stage kidney disease patients.
Area of Science:
- Pediatric Nephrology
- Public Health
- Epidemiology
Background:
- Paediatric kidney disease patterns vary globally due to genetic, racial, and environmental factors.
- Understanding local disease spectrum is crucial for targeted healthcare interventions.
Purpose of the Study:
- To review the spectrum and outcomes of childhood kidney diseases at Parirenyatwa Group of Hospitals.
- To identify challenges in providing care for paediatric kidney patients.
Main Methods:
- A retrospective observational study was conducted.
- Data collected for children under 16 hospitalized for kidney disease between January 1 and August 31, 2022.
- Kidney diseases were categorized according to standard definitions.
Main Results:
- Kidney diseases represented 2.2% of paediatric admissions (50 cases).
- Common diagnoses included acute kidney injury (32%), nephrotic syndrome (32%), hypertension (24%), and end-stage kidney disease (ESKD) (22%).
- Limited resources restricted dialysis availability, and the overall mortality rate was 32%, with the highest mortality in ESKD patients.
Conclusions:
- Childhood kidney disease significantly contributes to hospitalizations and mortality.
- There is a critical need for essential medications and kidney replacement therapy for children with kidney disease.
Background:
The pattern of paediatric kidney diseases across different regions is influenced by genetic, racial, and environmental differences.
Objectives:
The aim of this study was to review the current spectrum and outcome of childhood kidney diseases at Parirenyatwa Group of Hospitals and highlight the challenges of care.
Design:
Retrospective observational study.
Methods:
Data on all children below 16 years of age hospitalised for any kidney disease over an 8-month period (1 January-31 August 2022) were retrieved and retrospectively analysed. Kidney diseases were categorised as per standard definitions.
Results:
Kidney disease accounted for 2.2% (n = 50) of all 2264 admissions in the paediatric unit, with males constituting 60% (n = 30). Age ranged from 2 weeks to 13 years (mean 5.5 ± 3.5 years) with 58.0% being under 5 years. The commonest diagnoses in the unit were acute kidney injury (AKI) (n = 16, 32%) nephrotic syndrome (n = 16, 32%), hypertension (n = 12, 24%) and end stage kidney disease (ESKD) (n = 11, 22%) with some children presenting with more than 1 diagnosis. Only 3 out of 11 children with ESKD and 3 out of 8 children with AKI who required dialysis could be offered dialysis due to limited resources. Overall mortality rate was 32% (16/50): 5 children with AKI, 2 with nephrotic syndrome and normal kidney function, 8 with ESKD and 1 with Fanconi syndrome.
Conclusion:
Childhood kidney disease contributes significantly to hospitalisations at our institution with highest mortality among children with ESKD. The study highlighted the need for provision of essential drugs and kidney replacement therapy for children with kidney disease at our institution.
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