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. 2014 Feb 3:15:25.
doi: 10.1186/1471-2369-15-25.

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

Adanze O Asinobi, Adebowale D Ademola  1 , Oluwatoyin O Ogunkunle, Susan A Mott
Affiliations

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

Adanze O Asinobi et al. BMC Nephrol. .

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.

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Figures

Figure 1
Figure 1
Incidence, per million age related population, of end-stage renal disease (ESRD) for children and adolescents, by age group and time period: University College Hospital Ibadan, Nigeria.
Figure 2
Figure 2
Kaplan Meir survival curve of time from presentation in end-stage renal disease to in-hospital mortality, among 53 children and adolescents: University College Hospital Ibadan, Nigeria, 2005-2012.
Figure 3
Figure 3
Plot of survival of 53 children and adolescents from presentation in ESRD to in-hospital mortality, by acute dialysis management: University College Hospital Ibadan, Nigeria, 2005-2012.
See this image and copyright information in PMC

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