|Year : 2017 | Volume
| Issue : 1 | Page : 38-40
Paediatric renal diseases in a rural tertiary hospital in north-western Nigeria: pattern and outcome
Umma I Abdullahi M.B.B.S, F.W.A.C.P
Department of Paediatrics, Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria
|Date of Submission||19-Dec-2016|
|Date of Acceptance||04-Mar-2017|
|Date of Web Publication||13-Jun-2017|
Umma I Abdullahi
Department of Paediatrics, Federal Medical Centre, Birnin Kudu, P.O.Box 289, Kano State, Jigawa State
Source of Support: None, Conflict of Interest: None
The trend of paediatric kidney disease is steadily rising and is contributing significantly to childhood morbidity and mortality.
This study aimed at determining the trends, pattern, and outcome of renal diseases in children over a 10-year period.
Participants and methods
This was a retrospective study of all the consecutive children admitted with renal diseases from January 2006 to December 2015. All relevant data were extracted from their case notes and analyzed appropriately.
One hundred and two of 6269 children admitted during the study period had kidney disease, giving an overall prevalence of 1.2%. Sixty-one were boys whereas the remaining 41 were girls, with a male : female of 1 : 0.7. The age ranged from 10 to 180 months. There was a progressive increase in the number of admissions due to renal diseases from 0.9% in 2006 up to 3.4% in 2013 of the total annual admissions. Acute glomerulonephritis was the most common renal condition. The majority of children [94 (92.2%)] recovered fully, four (3.9%) were referred, one (0.98%) child left with his parents against medical advice, whereas three children died, giving a mortality rate of 2.9%.
There is a progressive increase in the prevalence of renal diseases among children studied, with acute glomerulonephritis being the most common condition seen.
Keywords: nigerian children, outcome, pattern, renal diseases
|How to cite this article:|
Abdullahi UI. Paediatric renal diseases in a rural tertiary hospital in north-western Nigeria: pattern and outcome. J Egypt Soc Nephrol Transplant 2017;17:38-40
|How to cite this URL:|
Abdullahi UI. Paediatric renal diseases in a rural tertiary hospital in north-western Nigeria: pattern and outcome. J Egypt Soc Nephrol Transplant [serial online] 2017 [cited 2017 Sep 20];17:38-40. Available from: http://www.jesnt.eg.net/text.asp?2017/17/1/38/207903
| Introduction|| |
Although the bulk of disease condition among children in the tropics and other developing world revolves around infections, infestations, malnutrition and other preventive conditions, diseases of the urinary system also do occur and are important causes of morbidity and mortality . Common renal diseases includes acute glomerulonephritis (AGN), nephritic syndrome and urinary tract infection ,,,,. Most of the paediatric kidney disease studies ,,, were conducted in urban centres where the standard of living and health-seeking behaviour is high and even among those studies the prevalence is variable mainly for reasons ranging from environmental and genetic factors  to also being a specialized tertiary centres with state of the art facilities for diagnosis and prompt treatment of these patients especially those with chronic kidney disease requiring dialysis.
It is, therefore, important to conduct this study in this locality that is mainly inhabited by peasants and predominantly from low economic cadre to determine the trends, pattern and outcome of renal diseases in rural part of north-western Nigeria. Findings of this study will not only add to the existing literatures but will also throw more light on trends, pattern and outcome of paediatric kidney diseases in rural children, which is very scarce. It will also assist in optimizing treatment and assist policy makers in effectively planning and execution of strategies to improve on patient care through provision of better diagnostic and treatment facilities.
| Participants and methods|| |
The study was conducted in Federal Medical Centre, Birnin Kudu, Jigawa State. Birnin Kudu, literally meaning southern city, is a town and a local government area in the south of Jigawa state, Nigeria, some 120 km southeast of Kano. As of 2007, the town of Birnin Kudu had an estimated population of 27 000. Birnin Kudu is an old historic town renowned for its rock and drawings found in some of them dating to centuries before the colonization of the northern Nigeria and establishment of native authority. The inhabitants are predominantly Hausa/Fulani Muslims and mostly subsistence farmers.
Federal Medical Centre is one of the tertiary health facilities in Jigawa state that was established in the year 2000 for the provision of service, teaching and research to cater for the needs of the local and wider community. Patients from other hospitals and clinics are referred here.
Paediatrics department is one out of the eight clinical departments in the hospital. The hospital has 200-bed capacity distributed among its various wards. The department comprises emergency paediatric unit, special care baby unit, paediatric medical world and children outpatient’s department. The department is manned by two paediatricians and six medical officers. Children who require dialysis are referred to Aminu Kano Teaching Hospital, which is 120 km from Birnin Kudu. The study was approved by hospital ethical research committee of the federal medical centre, Birnin Kudu.
All the consecutive admissions of the children in the Emergency Paediatric Unit admitted from January 2006 to December 2015 were noted in the unit register and their case notes retrieved. Information obtained included name, age, sex, duration of hospital stay, final diagnosis and admission outcome which may be discharge following full recovery, discharge against medical advice, death or referral.
Data were analyzed using the Statistical Package for Social Science software, version 17 (SPSS Inc., Chicago, IL). Continuous data were represented as mean or median as appropriate, whereas categorical data were presented as percentages. The prevalence of paediatrics renal disease was calculated as the proportion of the total number of paediatric admissions diagnosed with a renal condition.
| Results|| |
One hundred and two of 6269 children admitted during the study period had kidney disease, giving a prevalence of 1.2%. Sixty-one were boys and 41 were girls, with a male : female ratio of 1 : 0.67. Their ages ranged from 10 to 180 months ([Table 1]).
[Table 2] shows progressive increase in the number of admissions due to renal diseases from 0.9% in 2006 up to 3.4% in 2013 of the total annual admissions.
Common renal diseases were AGN [63 (61.8%)], nephrotic syndrome [24 (23.5%)] and urinary tract infection [10 (9.8%)]. Others were urolithiasis, pelvic kidney and Wilms’ tumour ([Table 3]).
The majority of children [94 (92.2%)] recovered fully and were discharged home and then were subsequently followed up. Four (3.9%) children were referred: one with AGN with complication for dialysis, two cases of Wilms’ tumour and one case of pelvic kidney. One (0.98%) child left with his parents against medical advice. Three children died, giving the mortality rate of 2.9% ([Table 4]).
| Discussion|| |
The prevalence of renal diseases among children presenting to this centre was found to be 1.6%. Interestingly, the trends of the renal diseases have steadily increased over the 10-year period, increasing from 0.9% in 2006 to almost four times of the total annual admission in 2013. The reported prevalence of 1.6% in this study is in keeping with 1.6%  and 1.3%  reported from south-south Nigeria. It is, however, lower than the 3.1%  found in Uyo south-south and 8.9%  from Lagos, south-western Nigeria, 6.9%  from Nepal and 3.3%  from Pakistan. The higher prevalence reported in their studies can partly be explained by the availability of well-established paediatric nephrology that can provide dialysis when necessary and hence most patients are promptly referred. Genetic and environmental factors may also play a role.
AGN was the most prevalent renal disease seen in this study, which is in keeping with the findings from northern Nigeria ,, Nepal  and Libya . However, other authors documented nephrotic syndrome as the most common cause of renal diseases in Nigeria and Pakistan . This, however, ranked second in this study. The variation in these studies may partly be explained by environmental and socioeconomic differences between the different regions where such studies were conducted. It is well established that there is a link between AGN and poor personal hygiene and environmental sanitation .
Urinary tract infection ranked the third cause of renal diseases in our study, which is in agreement with findings from Nepal  in sharp contrast to the findings from south-south region of Nigeria. The low prevalence of urinary tract infection in this study can been attributed to the fact that most of the cases of urinary tract infection were treated on outpatient basis, that is, were not severe enough to warrant admission into the ward.
| Conclusion|| |
The prevalence of renal disease is steadily increasing and the pattern is similar to what is obtained in the other centres. The increasing prevalence of kidney diseases in this study calls for improving diagnostic facilities and a well-equipped paediatric renal unit to cater for the increasing demand of renal replacement therapy.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Aikhionbare H. A nephrotic syndrome and acute glomerulonephritis. In: Azubuike JC, Nkanginieme KEO, editors. Paediatric and child health in a tropical region. 2nd ed. Owerri: African Educational Services; 2007. pp. 488–490.
Ugwu GI, Nwajei G, Chinelu U. Pattern of renal diseases among children in the Niger Delta Region, Nigeria. Arab J Nephrol Transplant 2014; 7:48–50.
Ezoeonwu B, Okike C, Oguonu T, Nwanko O. Pattern of renal diseases in children admitted into the paediatric ward. Afr J Paed Nephrol 2014; 1:8–11.
Ikpeme EE, Dixon-Umo OT. Paediatric renal diseases in Uyo, Nigeria: a 10 year review. Afr J Paed Nephrol 2014; 1:12–17.
Ladapo TA, Esezobor CI, Lesi FE. Pediatric kidney diseases in an African country: prevalence, spetrum and outcome. Saudi J Kidney Dis Transpl 2014; 25:1110–1116.
] [Full text]
Shankar PY, Shah GS, Mishra OP, Bara M. Pattern of renal diseases in children: a developing country experience. Saudi J Kidney Dis Transpl 2016; 27:371–376.
Rehman IJ, Khan MA. Pattern of renal diseases in children. J Pak Med Ass 1994; 44:118–120.
Abdurrahman MB, Babaoye FA, Aikhionbare HA. Childhood ‘renal disorders in Nigeria. Pediatr Nephrol 1990; 4:88–93.
Ocheke IE, Okolo SN, Bode-Thomas F, Agaba EI. Pattern of childhood renal diseases in Jos, Nigeria: a preliminary report. J Med Trop 2010; 12:20–25.
Elzouki AY, Amin F, Jaiswal OP. Prevalence and pattern of renal disease in eastern Libya. Arch Dis Child 1983; 58:106–109.
[Table 1], [Table 2], [Table 3], [Table 4]