Pattern of pediatric renal diseases in a rural tertiary care hospital
Keywords:Children, Nephrotic syndrome, Poststreptococcal glomerulonephritis, Renal disease
Background: Spectrum of renal disease varies in different population, geographical location, and by environmental factors. The purpose of this study was to find out the occurrence of different pediatric renal diseases at a teaching hospital in the rural part of Maharashtra, India.
Methods: All cases of renal diseases from one month to 12 years of age, admitted to the wards during the period of July 2018 to December 2019, were included in the study. Detailed clinical and laboratory evaluations were performed on all patients. Diseases were categorized as per standard definitions and managed with hospital protocols.
Results: Renal diseases accounted to be 235 cases (2.8%) of total pediatric admissions during study period, of which (61.3%) were male and (38.7%) female. Nephrotic syndrome (NS), was the most common disorder (34%) followed by congenital anomalies of the kidney and the urinary tract (CAKUT) (24.7%), urolithiasis (11%), urinary tract infection (10.63%), chronic kidney disease (CKD) (7.66%) and acute kidney injury (AKI) (3.83%). The causes of AKI were dehydration, urosepsis, septicemia, and acute glomerulonephritis (AGN). Mortality was found in 3.4% of cases and the etiologies were AKI, NS and CKD.
Conclusions: A substantial number of children are hospitalized with renal and urinary tract diseases. NS and congenital defects were the leading renal disorders in this study. These patients need comprehensive services for early identification and management.
Bhimma R, Kalo U. Childhood kidney diseases in developing countries: Is it a forgotten disease? S Afr J Child Health. 2016;10:103 4.
Ashraf M, Kumar V, Bano RA, Wani KA, Ahmed J, Ahmed K. Spectrum of Renal and Urinary Tract Diseases in Kashmiri Children. J Clin Diagn Res. 2016;10(6):1-2.
Bhatta NK, Shrestha P, Budhathoki S, Kalakheti BK, Poudel P, Sinha A, Singh R. Profile of renal diseases in Nepalese children. Kathmandu Uni Med J. 2008;6(2):191-4.
Sonowal R. Profile of Renal Diseases in North-East Indian Children. Saudi J Kidney Dis Transpl. 2019;30(5):1151-5.
Barman H, Sangla L, Ksoo R, Rapthap K. Pattern of Pediatric Kidney Diseases in a Tertiary Care Center in Northeast India: a 5-year Retrospective Analysis. J Ped Nephrol. 2018;6(2).
Abou Chaaban M, Al Murbatty B, Majid MA. Spectrum of pediatric renal diseases in Dubai. Saudi J Kidney Dis Transpl. 1997;8:310 3.
Qader A, Muin Uddin G, Rahman H, Hanif M, Roy RR, Begum A, et al. Renal Diseases in Children Attending Pediatric Nephrology Centers of Dhaka City. J Ped Nephrol. 2016;4(3):86-91.
Moorani KN, Asim S, Shahid A. Pattern of Kidney Diseases in Children. Pak Pediatr J. 2013:37(1):26-33.
Malla T, Malla KK, Thapalial A, Sharma MS. An Overview of Renal Diseases in Children in Pokhara. J Nepal Paediatr Soc. 2007:27(2):75-8.
Yadav SP, Shah GS, Mishra OP, Baral N. Pattern of Renal Diseases in Children: A Developing Country Experience. Saudi J Kidney Dis Transpl. 2016;27(2):371-6.
KDIGO Glomerulonephritis Work Group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Int Suppl. 2012;2:139-274.
Rees L, Brogan PA, Bockenhauer D, Webb NJ. Glomerular diseases. In: Paediatric Nephrology. 2nd ed. Oxford, London: Oxford University Press. 2012;192-216.
Vijayakumar M, Kanitkar M, Nammalwar BR, Bagga A. Revised statement on management of urinary tract infections. Indian Pediatr. 2011;48:709-17.
Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380:756-66.
Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20:629-37.
Senac MO, Miller JH, Stanley P. Evaluation of obstructive uropathy in children: Radionuclide renography vs. the Whitaker test. AJR Am J Roentgenol. 1984;143:11-5.
National Kidney Foundation. Kidney Disease outcome quality initiative clinical guidelines for chronic disease: Evaluation, classification and stratification, part IV definition and classification of stages of chronic kidney disease. Am J Kidney Dis. 2002;39:46-75.
Ladapo TA, Esezobor CI, Lesi FE. Pediatric kidney diseases in an African country: Prevalence, spectrum and outcome. Saudi J Kidney Dis Transpl. 2014;25:1110-6.
Derakhshan A, Hashemi GHA, Fallahzadeh MH. Spectrum of In-patient Renal Diseases in Children “A Report from Southern Part Islamic Republic of Iran”. Saudi J Kidney Dis Transplant. 2004:15(1):12-7.
Ali SH, Hussien FS, Al-Amer HA. Profile of Renal Diseases in Iraqi Children: A Single-Center Report. Saudi J Kidney Dis Transpl. 2015;26(3):613-8.
Ocheke IE, Okolo SN, Thomas FB, Agaba EI. Pattern of childhood renal diseases in Jos, Nigeria: A preliminary report. J Med Trop. 2010;12:52-5.
Srivastava RN, Mayekar G, Anand R, Choudhry VP, Ghai OP, Tandon HD. Nephrotic syndrome in Indian children. Arch Dis Child. 1975;50:626-30.
Etuk IS, Anah MU, Ochighs SO, Eyong M. Pattern of paediatric renal disease in inpatients in Calabar, Nigeria. Trop Doct. 2006;36:256.
Anigilaje EA, Adesina TC. The pattern and outcomes of childhood renal diseases at University of Abuja Teaching Hospital, Abuja, Nigeria: A 4 year retrospective review. Nigerian Postgrad Med J. 2019;26:53-60.
Kanitkar M. Chronic kidney disease in children: An Indian perspective. Med J Armed Forces India. 2009;65:45-9.