SPECTRUM OF KIDNEY DISEASES IN ADOLESCENT POPULATION: A SINGLE-CENTER STUDY.

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-3276, Poster Board= FRI-148

Introduction:

Adolescence is crucial time for growth and psychosocial development. Adolescents have different spectrum of etiologies as compared to adult population. Quality of life is significantly lower in adolescents with kidney disease, due to debilitating impact of the disease, limiting participation in school and social activities and cost of treatment.

Methods:

STUDY POPULATION:

This study included patients of age 13y-19y admitted and referred to nephrology department for management.

 STUDY PERIOD:

December 2020 to August 2024.

 METHODOLOGY:  Data was obtained from medical records of the patients. Baseline data included age, gender, clinical presentation, comorbidities, indications for Renal Replacement Therapy. Lab parameters on 1st day of admission were included. Indications for biopsy and biopsy reports were recorded.

TYPE OF STUDY:

Retrospective, 0bservational study.

Results:

CLINICO- DEMOGRAPHIC PROFILE, COMORBIDITIES OF ADOLESCENTS ADMITTED IN NEPHROLOGY DEPARTMENT

VARIABLE

NO OF PATIENTS -88(100%)

  

MEAN AGE (YEARS)

15.5 +/- 1.7

  

GENDER

M: F

1.1:1

DURATION OF STAY(days)

15 +/- 10

  

CLINICAL PRESENTATION

 

  

BREATHLESSNESS

17.04% (29)

  

PEDAL ODEMA

30.6% (51)

  

VOMITINGS

17.04% (29)

  

OLIGURIA

13.6%  (23)

  

FEVER

11.36% (19)

  

LOIN PAIN

2.2% (3)

  

HEADACHE

4.54%  (7)

  

UGI BLEED

1.1      (2)

  

SEIZURES

2.2% (3)

  

HEMATURIA

12.5% (5)

  

COMORBIDITIES

 

  

HTN

25.86% (43)

  

DM

2.3% (4)

  

OTHERS

18.1% (31)

  

LAB PARAMETERS

MEAN + SD

  

HB (g/dL)

8.9 + 3.5

  

WBC (thousand)

7.25 + 5.37

  

PLT (lakhs)

2.87 + 1.48

  

Blood Urea (mg/dL)

76.1 + 48

  

CREATININE AT ADMISSION (mg/dL)

6.4 + 5.9

  

CREATININE AT DISCHARGE (mg/dL)

5.5+ 4.6

  

AST/ALT (IU/L)

22+ 8.2/18+ 8.0

  

ALBUMIN  (g/dL)

2.9 + 0.8

  

PROTEINURIA

    

NIL

7.95%

  

TRACE/ 1+

27.29%

  

2+

23.86%

  

> 3+

40.9%

  
     

 

 

 

SPECTRUM OF RENAL DISEASE IN STUDY POPULATION:

SPECTRUM OF RENAL DISEASES

PERCENTAGE

AKI

25.5% (43)

ACUTE ON CKD

2.9%(5)

CKD 5D

23.8% (40)

GLOMERULAR

  

NEPHROTIC SYNDROME

32.7% (55)

NEPHRITIC SYNDROME

11.3% (19)

OTHERS

3.5% (6)

 

 

 

ETIOLOGY OF RENAL DISEASE IN STUDY POPULATION:

 

 

ETIOLOGY

 

AKI

 

 

 

PRERENAL

 

 

  

INTRINSIC

SEPSIS

5.9% (10)

  

PRAKI

5.3% (9)

    

POISONING

7.1% (12)

    

AFI

2.9% (4)

    

SNAKE BITE

1.1% (2)

    

OTHERS

3.5% (6)

    

ACUTE ON CKD

SEPSIS

2.9% (5)

  

CKD 5D

 

23.8% (40)

  

 

 

 

 

BIOPSY FINDINGS IN STUDY POPULATION:

INDICATION

 

  

NEPHROTIC

MEMBRANOUS NEPHROPATHY

1.1%(2)

MINIMAL CHANGE DISEASE

9.5%(16)

  

FSGS

7.1%(12)

  

NEPHRITIC

 

LUPUS NEPHRITIS

6.5%(11)

IGA NEPHROPATHY

1.1%(2)

  

IRGN

3.5%(6)

  

NON RECOVERING AKI

ACN

0.5%(1)

 

 

NEED FOR RRT IN STUDY POPULATION:

 

HD

PD

CRRT

Transplant

AKI

13.6 % (23)

2.9% (5)

7.7% (13)

-

CKD

20.2% (34)

3.5% (6)

-

1.1%(2)

 

 

OUTCOMES OF AKI IN STUDY POPULATION AT TIME OF DISCHARGE:

OUTCOMES OF AKI

Total patients-43

DEATH

33.3% (14)

PARTIAL RENAL RECOVERY

12.5% (6)

COMPLETE RENAL RECOVERY

29.1% (12)

NO RECOVERY

-

LOST TO F/U

25.5% (11)

Conclusions:

CONCLUSION:

·       Nephrotic syndrome was the most common presentation –32.7 %, followed by AKI 25.5%.

·       HD support was required in 95.3% pts of AKI.

·       CRRT was done in 30% of AKI patients .

·       Mortality  in AKI group 33%.

·       Complete recovery was noticed in 29.1% of AKI pts.

LIMITATIONS OF THE STUDY

·       Genetic analysis couldn’t be done in all cases of SRNS/FSGS/CAKUT

·       Electron microscopy studies couldn’t be done for all the MCD-FSGS patients.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.