Challenges Encountered in the Care of Adolescents with Kidney Disease

Abstract

Background:  As adolescents (persons aged 10-19 years) have the potential to affect national development, managing their health is important. Chronic kidney disease (CKD) is a major cause of mortality worldwide and adolescents with CKD have a higher mortality than their healthy peers.  Sub-Saharan Africa (SSA) has the fastest growing adolescent population in the world, but few studies describe challenges healthcare workers in SSA face, caring for adolescents with kidney disease.  Such knowledge could improve patient care and prevent adolescents developing CKD.

Case-series: Report of four adolescents with kidney disease (nephrotic syndrome, HIV Associated Nephropathy, pelviureteric junction obstruction), seen in a tertiary hospital in Nigeria, selected because their management was particularly challenging.  Poor adherence to prescribed therapy and depression were major challenges. Others were managing poor perception of illness, school problems and risky behaviour (handling chemicals with bare hands).  Inability to enforce adherence and financial constraints led to parental frustration. Two patients improved with counselling and support. Two died – one from severe respiratory disease, one from kidney failure.

Conclusion: Adolescents should be routinely screened for adherence, depression, and risky behaviours. Attention should be paid to socioeconomic issues of parents. Research is needed to identify other challenges especially those peculiar to SSA.