Chronic kidney disease in children at the University of Abuja Teaching Hospital, Abuja, Nigeria (2017-2020)

Abstract

Background: Childhood chronic kidney disease (CKD) is increasing globally, and it is associated with significant morbidity and mortality. This article describes the incidence, pattern, and outcomes of childhood CKD at the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria.

Materials and Methods: This was a retrospective review of children aged 1 month to 16 years seen at the Department of Paediatrics, UATH, from January 2017 to December 2020.

Results: Ninety-four cases of CKD were seen with an incidence rate of 36 per million-child population per year. The age range was between 1 month and 16 years, with a mean age of 7.7 ± 4.1 years, and a majority (41, 43.6%) was between 5 and 10 years. The commonest causes of CKD were nephrotic syndrome (NS) (58, 61.7) and posterior urethral valve (PUV) (14, 14.8%). There was a male predominance (71/94, 75.5%) which was not statistically significant (p=0.157). Eleven (11.7%) subjects in end-stage kidney disease (ESKD) had chronic intermittent haemodialysis over a mean duration of 2 months before cardiovascular-related mortality ensued. Most of the mortality was from steroid-resistant idiopathic NS (5/11, 45.5%) and PUV (2/11, 18.2%). A child with idiopathic steroid- resistant NS who had living unrelated renal transplantation is surviving.   

Conclusion: The incidence of childhood CKD is high, and it is commoner among school-age children. The commonest CKD was NS and PUV. Financial constraints limit the accessibility of kidney replacement therapy (KRT) among those with ESKD. The need for preventive nephrology and public-funded KRT cannot be over-emphasized.