Author(s): Asinobi AO, Ademola AD, Ogunkunle OO, Mott SA, Asinobi AO, Ademola AD, Ogunkunle OO, Mott SA, Asinobi AO, Ademola AD, Ogunkunle OO, Mott SA, Asinobi AO, Ademola AD, Ogunkunle OO, Mott SA
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Abstract BACKGROUND: Children and adolescents with end-stage renal disease (ESRD) in sub-Saharan Africa may have the worst outcomes globally. Barriers to management include late presentation, poor socioeconomic conditions, absence of medical insurance, limited diagnostic facilities and non-availability of chronic renal replacement therapy (RRT). Our study was to determine the incidence, aetiology, management and outcomes of paediatric ESRD in a tertiary hospital in Nigeria. METHODS: A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012. RESULTS: 53 patients (56.6\% male), median age 11 (inter quartile range 8.5-12) years were studied. Mean annual incidence of ESRD in Ibadan for children aged 14 years and below was 4 per million age related population (PMARP) while for those aged 5-14 years it was 6.0 PMARP. Glomerulonephritis was the cause in 41 (77.4\%) patients amongst whom, 29 had chronic glomerulonephritis and 12 had nephrotic syndrome. Congenital anomalies of the kidneys and urinary tract (CAKUT) accounted for 11 (21.2\%) cases, posterior urethral valves being the most common. Acute haemodialysis, acute peritoneal dialysis or a combination of these were performed in 33 (62.3\%), 6 (11.3\%) and 4 (7.5\%) patients respectively. Median survival was 47 days and in-hospital mortality was 59\%. CONCLUSIONS: Incidence of paediatric ESRD in Ibadan is higher than previous reports from sub-Saharan Africa. Glomerulonephritis, and then CAKUT are the most common causes. Mortality is high, primarily due to lack of resources. Preventive nephrology and chronic RRT programmes are urgently needed.
This article was published in BMC Nephrol
and referenced in Clinical Microbiology: Open Access