Paediatric end-stage renal disease in a tertiary hospital in South West Nigeria

• Published in: BMC nephrology Vol. 15; no. 1; p. 25
• Main Authors: Asinobi, Adanze O, Ademola, Adebowale D, Ogunkunle, Oluwatoyin O, Mott, Susan A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.02.2014; BioMed Central
• Subjects: Adolescent; Age Distribution; Care and treatment; Child; Child, Preschool; Children; Children & youth; Chronic illnesses; Chronic kidney failure; Colleges & universities; Computer software industry; Diseases; Female; Health insurance; Health Services Accessibility - statistics & numerical data; Hospitals; Humans; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Mortality; Nephrology; Nigeria - epidemiology; Peritoneal dialysis; Prevalence; Risk Factors; Sex Distribution; Socioeconomic Factors; Survival Rate; Tertiary Care Centers - statistics & numerical data; Tertiary Healthcare - statistics & numerical data; Nigeria; United States; Queensland Australia; Australia
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/1471-2369-15-25

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. A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012. 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%. 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.