Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon.
We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013. Renal failure referred to either acute kidney injury (AKI) or Stage 3–5 chronic kidney disease (CKD). AKI was defined and graded using either the modified RIFLE criteria or the Pediatrics RIFLE criteria, while CKD was graded using the KDIGO criteria. Outcomes of interest were need and access to dialysis and in-hospital mortality. For patients with AKI renal recovery was evaluated at 3 months.
Median age was 84 months (1QR:15–144) with 62.1% males. Frequent clinical symptoms were asthenia, anorexia, 68.8% of participants had anuria. AKI accounted for 84.5% (n = 87) and CKD for 15.5% (n = 16). Chronic glomerulonephritis (9/16) and urologic malformations (7/16) were the causes of CKD and 81.3% were at stage 5. In the AKI subgroup, 86.2% were in stage F, with acute tubular necrosis (n = 50) and pre-renal AKI (n = 31) being the most frequent mechanisms. Sepsis, severe malaria, hypovolemia and herbal concoction were the main etiologies. Eight of 14 (57%) patients with CKD, and 27 of 40 (67.5%) with AKI who required dialysis, accessed it. In-hospital mortality was 50.7% for AKI and 50% for CKD. Of the 25 patients in the AKI group with available data at 3 months, renal recovery was complete in 22, partial in one and 2 were dialysis dependent. Factors associated to mortality were young age (p = 0.001), presence of a coma (p = 0.021), use of herbal concoction (p = 0.024) and acute pulmonary edema (p = 0.011).
Renal failure is severe and carries a high mortality in hospitalized children in Cameroon. Limited access to dialysis and lack of specialized paediatric nephrology services may explain this dismal picture.
Cochat P, Mourani C, Exantus J, Bourquia A, Martinez-Pico M, Adonis-Koffy L, et al. Pediatric nephrology in developing countries. Medecine tropicale. 2009;69(6):543–7. PubMed
Alebiosu CO, Ayodele OE. The global burden of chronic kidney disease and the way forward. Ethnicity & disease. 2005;15(3):418–23.
Etuk IS, Anah MU, Ochighs SO, Eyong M. Pattern of paediatric renal disease in inpatients in Calabar, Nigeria. Trop Dr. 2006;36(4):256.
Onifade EA. Ten-year review of childhood renal admissions into the Lagos University teaching hospital, Nigeria. Nigerian Quarterly Journal of Hospital Medicine. 2003;13(3–4):1–5.
Michael IO, Gabriel OE. Pattern of renal diseases in children in midwestern zone of Nigeria. Saudi Journal of Kidney Diseases and Transplantation. 2003;14(4):539. PubMed
Ocheke IE, Okolo SN, Bode-Thomas F, Agaba EI. Pattern of childhood renal diseases in Jos, Nigeria: a preliminary report. Journal of Medicine in the Tropics. 2010;12(2)
Bhatta N, Shrestha P, Budhathoki S, Kalakheti B, Poudel P, Sinha A, et al. Profile of renal diseases in Nepalese children. 2008.
Assounga AG, Assambo-Kieli C, Mafoua A, Moyen G, Nzingoula S. Etiology and outcome of acute renal failure in children in congo-brazzaville. Saudi journal of kidney diseases and transplantation. 2000;11(1):40–3. PubMed
Anochie I, Eke F. Chronic renal failure in children: a report from Port Harcourt, Nigeria (1985-2000). Pediatr Nephrol. 2003;18(7):692–5. PubMed
Rahman MH, Karim MA, Hoque E, Hossain MM. Chronic renal failure in children. Mymensingh medical journal : MMJ. 2005;14(2):156–9. PubMed
Assounga AG, Assambo-Kieli C, Mafoua A, Moyen G, Nzingoula S. Etiology and outcome of acute renal failure in children in Congo-Brazzaville. Saudi Journal of Kidney Diseases and Transplantation. 2000;11(1):40. PubMed
Esezobor C, Oniyangi O, Eke F. Paediatric dialysis services in Nigeria: availability, distribution and challenges. West Afr J Med. 2011;31(3):181–5.
Bellomo R, Ronco C, Kellum J, Mehta R, Palevsky P. Acute renalfailure – definition, outcomemeasures, animal models, fluidtherapy and information technologyneeds: the second international consensus conference of the acute DialysisQuality initiative (ADQI) group. Crit Care. 2004;8(4):R204–12. CrossRefPubMedPubMedCentral
Kramer H. The national kidney foundation's kidney disease outcomes quality initiative (KDOQI) grant initiative: moving clinical practice forward: WB Saunders; 2010.
Hogg R, Furth S, Lemley K, Portman R, Schwartz G, Coresh J, et al. National Kidney Foundation’s kidney disease outcomes quality initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics. 2003;111(6 Pt 1):1416–21. CrossRefPubMed
Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin N Am. 1987;34(3):571–90. CrossRef
Cerdá J, Bagga A, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nature clinical practice. Nephrology. 2008;4(3):138–53. PubMed
Ulasi I. Gender bias in access to healthcare in Nigeria: a study of end-stage renal disease. Trop Dr. 2008;38(1):50–2.
Obiagwu PN, Abdu A. Peritoneal dialysis vs. haemodialysis in the management of paediatric acute kidney injury in Kano, Nigeria: a cost analysis. Tropical Med Int Health. 2015;20(1):2–7. CrossRef
Derakhshan A, Al Hashemi GH, Fallahzadeh MH. Spectrum of in-patient renal diseases in children "a report from southern part Islamic Republic of Iran". Saudi Journal of Kidney Diseases and Transplantation. 2004;15(1):12. PubMed
Radi MA. Childhood renal disorders in Jordan. J Nephrol. 1995;8:162–6.
Ali E-TM, Rahman AH, Karrar ZA. Pattern and outcome of renal diseases in hospitalized children in Khartoum state. Sudan Sudanese Journal of Paediatrics. 2012;12(2):52.
Michael IO, Gabriel OE. Pattern of renal diseases in children in midwestern zone of Nigeria. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2003;14(4):539–44.
Ehlayel M, Akl K. Childhood chronic renal failure in Qatar. The British journal of clinical practice. 1991;46(1):19–20.
Bah A, Kaba M, Diallo M, Kake A, Balde M, Keita K, et al. Renal diseases--morbidity and mortality in nephrology service, National Hospital Donka. Le Mali medical. 2005;21(4):42–6.
Arogundade F, Sanusi A, Okunola O, Soyinka F, Ojo O, Akinsola A. Acute renal failure (ARF) in developing countries: which factors actually influence survival. The Central African journal of medicine. 2006;53(5–8):34–9.
Balaka B, Douti K, Gnazingbe E, Bakonde B, Agbere A, Kessie K. Etiologies et pronostic de l’insuffisance rénale de l’enfant à l’hôpital universitaire de Lomé. Journal de la Recherche Scientifique de l'Universite de Lome. 2012;14(1).
Chijioke A, Makusidi A, Rafiu M. Factors influencing hemodialysis and outcome in severe acute renal failure from Ilorin, Nigeria. Saudi Journal of Kidney Diseases and Transplantation. 2012;23(2):391. PubMed
Ponsar F, Tayler-Smith K, Philips M, Gerard S, Van Herp M, Reid T, et al. No cash, no care: how user fees endanger health—lessons learnt regarding financial barriers to healthcare services in Burundi, Sierra Leone, Democratic Republic of Congo, Chad, Haiti and Mali. International Health. 2011;3(2):91–100. CrossRefPubMed
- Epidemiology and outcomes of children with renal failure in the pediatric ward of a tertiary hospital in Cameroon
Marie Patrice Halle
Carine Tsou Lapsap
Beatrice Kaptue Moudze
Christophe Adjahoung Akazong
Eugene Belley Priso
- BioMed Central
Neu im Fachgebiet Pädiatrie
Meistgelesene Bücher aus dem Fachgebiet
e.Med Kampagnen-Visual, Mail Icon II