Back
The availability of epidemiological data related to chronic kidney disease (CKD) in
pediatrics is limited, with factors that are not yet understood. The available information comes mainly
from records of patients on dialysis, with little information related to the initial stages of the disease. The
purpose of this study is to analyze the epidemiology of CKD in pediatric patients with a gender approach.
Patients with CKD under 18 years of age were included, from various regions of the country
who consulted at two Reference hospitals, located in Asunción (Central Hospital-IPS) and the
Metropolitan Area (National Hospital), during the period 2000 to 2020. Sociodemographic and clinical
variables, social security cover, dialysis requirement and mortality were analyzed. The analysis was
performed using EPI INFO 7.2.3 software. Frequencies and proportions were calculated for the
qualitative variables, whereas for the quantitative variables their normality was evaluated, presenting
the results as median and interquartile range (IQR). The underlying disease, treatment and mortality
were correlated according to the sociodemographic variables, with a significance level established at p <
0.05.
216 patients were included, of which 50% were women. The median age was 7 years (IQR 3-12),
with ages ranging from 1 month to 17 years. 42.6% were adolescents (Table 1). Residence area: 50%
came from Asunción and the metropolitan area (Asu/MA). 59.2% of patients did not have social security.
Underlying disease: uropathies: 57.4%, glomerulopathies: 19.9%, unknown: 14.3%, polycystic kidney
disease: 6.9%, tumor: 1.4%. 55.8% required dialysis. 83.1% received hemodialysis. Death: 27.3%. 11.6%
of patients underwent transplantation, of which 96% had social security. The median age at admission of
those who underwent dialysis was 10 years vs. 4 years of those who did not (p:0.000001). There was an
age difference based on gender, with the median being 10 years (IQR 4-12.5) in women and 6 years (IQR
3-11) in men (p=0.01). Men came mainly from Asu/AM: 60.8% vs 39.2% (p:0.007). There were no
differences when comparing gender and social security. Uropathies were more frequent in men (67.6%
vs 47.2%), while glomerulopathies and CKD of unknown etiology were more common in women (23.1%
vs 16.6% and 19.4% vs 9.2%, respectively) p:0.02. There was a significant difference in dialysis modality
based on gender, 9.6% of women received peritoneal dialysis vs 25.5% of men (p:0.01). 21% of men and
women died. 11.9% of women and 12% of men received a transplant p: NS.
Women consulted later than men. Unknown etiology and glomerulopathies were more
frequent in women. A higher percentage of men received peritoneal dialysis. A small number of patients
received a transplant.