Introduction:
Pediatric nephrology represents a major challenge in France. According to figures provided in the white paper on pediatric nephrology, written by the pediatric nephrology society in 2017 in France 110 children were transplanted each year 1500 to 2000 children lived with chronic kidney disease, 850-900 children had kidney failure, 20 to 25000 hemodialysis-plasmapheresis-immunoadsorption sessions were performed. The incidence and prevalence of stage 2-5 chronic kidney disease remain poorly understood. However, rare population-based studies suggest that the prevalence of chronic kidney disease, all stages combined, may concern 1% of the paediatric population. In French Guiana (FG), data are almost non-existent, as pediatric nephrology activity is not yet structured. The aim of this study is to provide an overview of pediatric nephrology in French Guiana, with a view to identifying ways of improving care for children suffering from kidney disease.
Methods:
This is a single-center retrospective study describing pediatric nephrology activity in the pediatric department of the Centre hospitalier de l'ouest Guyanais from January 2018 to December 2023.
Results:
Renal damage is dominated by acute tubulointerstitial nephritis, with an annual average of around 40%, followed by acute and chronic glomerular damage at around 20%, and pyelonephritis at around 11%. Acute glomerular disease is dominated by acute post-infectious glomerulonephritis, while chronic glomerulonephritis is either primary, in the context of idiopathic nephrotic syndrome, or secondary, in the context of systemic lupus erythematosus or sickle cell disease, with particularly high prevalence. Congenital nephropathies include dysplasia and bilateral renal hypoplasia (4%), most often as part of a dysgenic syndrome. Malformative uropathy is dominated by the posterior urethral valve. Certain tropical etiological features are encountered, notably schistosomiasis and paraquat intoxication. Renal biopsy, when possible, is carried out by nephrologists and, if indicated, hemodialysis is the only extra-renal purification modality used when the criteria are met. Peritoneal dialysis is not yet performed, and the pediatric renal transplant pathway is not organized.
Conclusions:
Nephropathies are frequent and varied in the Guyanese pediatric population, and require a structured approach to their management through the establishment of a nephropediatric network and the development of certain techniques such as peritoneal dialysis, as well as the organization of a pediatric renal transplant pathway.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.