CHRONIC KIDNEY DISEASE - EPIDEMIOLOGY AND OUTCOMES AT A TERTIARY PAEDIATRIC INSTITUTION

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CHRONIC KIDNEY DISEASE - EPIDEMIOLOGY AND OUTCOMES AT A TERTIARY PAEDIATRIC INSTITUTION

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Co-author 1

Stefan Brown stefan.brown93@icloud.com University of the West Indies Child & Adolescent Health Kingston Jamaica -

Co-author 2

Sandrica Young Peart sandricap@yahoo.com University of the West Indies Child & Adolescent Health Kingston Jamaica *

Co-author 3

Natalie McNeil Beecher natalietbeecherwbs@gmail.com University of the West Indies Child & Adolescent Health Kingston Jamaica -

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Introduction

Chronic Kidney Disease (CKD) is increasingly recognized as a major conundrum in public health on a global scale. Although there is an abundance of epidemiological research on CKD within the adult population, there remains a paucity of published data for children. This lack of information is even more pronounced in the English-speaking Caribbean, thereby highlighting the urgent need to define the burden, distribution, and outcomes of CKD in the paediatric population.

Methods

This is a retrospective, descriptive study to describe the epidemiology and outcomes of CKD in children under twelve years presenting to a tertiary pediatric institution between January 1, 2010, and December 31, 2020. Medical records fulfilling inclusion criteria were reviewed via a data extraction sheet over three to six months, following ethical approval. Data were analyzed using SPSS version 29.0.2.0.

Results

Fifty-five cases met the inclusion criteria. The prevalence was 46.96 per 100,000. There was a male predominance (43 cases, 78%). The most common presenting symptoms were vomiting (36, 65.5%) and fever (29, 52.7%). CAKUT accounted for 28 cases (50.9%) with obstructive uropathy due to posterior urethral valves (18, 32.7%) the main etiology. Renal scarring secondary to recurrent urinary tract infection (17, 30.9%) was prominent. The mean eGFR at diagnosis was 74 ml/min/m² (Stage 2 CKD), improving to 124.87 ml/min/1.73m² (Stage 1 CKD) after three months. Anemia(47.3%) and hypertension (36.4%) were the main complications at diagnosis. Improvements were noted at one and two years follow up 38.2%, and 18.2% for anemia, and 23.6%, and 9.1% for hypertension respectively. Twenty-one children (38.2%) defaulted follow-up.

Conclusion

Compared to locally conducted studies, the incidence of CKD is rising, with CAKUT strongly associated with pediatric CKD. Local protocols are essential for early detection, targeted interventions, and effectively reducing progression to ESRD. Further prospective studies are needed.

Kewords