KUMJ | VOL. 20 | NO. 2 | ISSUE 78 | APRIL - JUNE 2022
Clinico-epidemiological Profile of Children with Chronic Kidney Disease in Tertiary Care Referral Center in Nepal: Prospective observational study
Poudel DR, Basnet S, Shrestha LP
Abstract: Background
Chronic kidney disease in children has been increasing over the years and is
associated with high degree of morbidity and mortality. The cost of treating children
with chronic kidney disease is also substantial. Prevention of this disease is the only
long term solution in our context. Till date, there is limited data on chronic kidney
disease in Nepalese children.
Objective
To study the epidemiological, clinical and etiological profile of children with Chronic
Kidney Disease from 2 to 16 years of age presenting for the first time in tertiary care
hospital.
Method
This is the prospective observational study carried out at the tertiary care hospital
over a period of 3 years. Children between 2-16 years who were first time diagnosed
of chronic kidney disease and had estimated glomerular filtration rate < 60 ml/
min/1.73 m
2
for last 3 months were enrolled.
Result
There were total of 124 patients, of whom 78 were male with male to female ratio
of 5:3 with mean age of 11.8±2.2 years. Chronic glomerulonephritis (23%), reflux
nephropathy (23%) and nephrolithiasis (16%) were the commonest etiological
diagnosis. Rapidly progressive glomerulonephritis and systemic lupus erythematous
accounted for 85% cases of chronic glomerulonephritis. Vesicoureteric reflux and
posterior urethral valve accounted for 85% cases of reflux nephropathy. In 32%, the
cause could not be determined. Swelling (45%) and dyspnea (20%) were the chief
presenting complaints. Pallor were seen in all cases (100%) followed by hypertension
in 68% and short stature in 64%. Majority (60%) of the patients with chronic kidney
disease presented in the stage V.
Conclusion
Chronic glomerulonephritis and reflux nephropathy were the commonest
etiologies of chronic kidney disease, majority of them following rapidly progressive
glomerulonephritis, systemic lupus erythematosis, vesicoureteric reflux and
posterior urethral valve. The commonest clinical features were swelling, dyspnea,
pallor and hypertension.
Keyword : Chronic kidney disease, Clinical profile, Epidemiological profile, ESRD, Etiology of CKD, Nepalese children