Admission pattern and outcomes of renal diseases among hospitalized children at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Abstract Background: Renal disorders in children constitute important causes of morbidity and mortality worldwide especially in developing countries where advanced diagnostic and treatment facilities are very limited and generally not affordable. A delay in presentation and diagnosis together with limited resources contribute to the poor treatment outcomes. Knowledge of the pattern of prevailing renal diseases and possible etiological factors allows for a more focused preventive nephrology that reduces burden of renal diseases. This study determines the pattern and the outcomes of childhood renal diseases. Methods: A cross-sectional retrospective medical record review done among all patients between the age of 7 days to 15years admitted to pediatric ward and PICU from September 11, 2017 to September 10, 2020 at saint Paul hospital millennium medical college, Addis Ababa, Ethiopia. Date were collected using structured questionnaire developed for this study and entered using EpiData version 3.1 and exported to IBM SPSS Statistics for Windows, Version 26. Results were presented as frequencies and percentages. Selected characteristics were tested for associations with chi-square and student’s t test. The level of significance was set at P < 0.05. Results: Out of 3,212 pediatric admissions, 175 had renal disorders accounting of 5.5% of all admission of which Ninety-three (53.1%) were males and 82(46.9%) were females. The mean age of presentation was 7.8 ±4.4 years. The most common renal disease in the study was Acute glomerulonephritis 73(41.7%) followed by Nephrotic syndrome 32(18.3%), Acute kidney injury 22(12.6%) and CAKUT 10(5.7%). Other cases were chronic kidney disease and urinary tract infection each 9(5.1%), Hemolytic uremic syndrome 8(4.6%), Lupus nephritis 5(2.9%). Regarding the outcome, 122(69.7%) discharged improved, 13(7.4%) DAMA, 11(6.3%) referred, 13(7.4%) progressed to CKD and 8(4.6%) death. The most common cause of death was AGN 3(1.7%) followed by AKI 2(1.1%). Conclusions: This study shows majority of patients were AGN of post infectious cause and Nephrotic syndrome of having unfavorable outcome. Emphasizing on infection control strategy, early detection and appropriate treatment, and effective referral systems decreases the disease burden. Key words: renal disease, pattern, Ethiopia