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Etiologies et pronostic de l’insuffisance rénale de l’enfant à l’hôpital universitaire de Lomé
Abstract
Aim: Renal failure (RF) was investigated to determine the prevalence of RF clinical types, aetiology, comorbidities, and outcome in children at the university hospital of Lomé.
Methods: Consecutive cases of RF admitted from January, 2005 through December, 2007 were prospectively studied. Informations about age, gender, body surface area, urine volume per day, early or late presentation, clinical features, aetiology, comorbidities, dialysis need, laboratory investigations, admission duration and outcome in each patient were obtained.
Results: Out of 14468 children admitted in the study period 92 (0.63%) presented RF. There were 50 boys and 42 girls (sex ratio: 1.19); mean age was 6.30 ± 5 years. Most of the patients (80.44%) presented late, at least 1 week after renal failure onset. Acute (80.43%) or chronic (19.57%), Oliguric (45.65%), nonoliguric (36.95%) and anuric (17.39%) RF were the identified clinical types. Dialysis requirement concerned 50 patients (54.34%) of whom oliguric (68%) and anuric (32%) RF cases, but only 20% of them were dialyzed. Primary and secondary aetiologies accounted for 39.13% and 60.87% of RF respectively. Nephrotic syndrome (17.39%) and glomerulonephritis (6.52%) were the major primary etiologies. Of acute RF. Plasmodium falciparum malaria (21.73%) and septicaemia (15.21%) were the major secondary aetiologies. Anaemia was present in all patients and was the most frequent comorbidity. It occurred alone (23.91%) or in combination with other comorbidities (76.08%). Late presentation of the patients (80.44%), nondialysis (80%), primary etiology (39.13%) and presence of more than one comorbidities (76.08%) correlated significantly with mortality. Overall mortality rate was 47.82%. Financial constraints on the part of parents of patients, lack of dialysis and paediatric nephrology units were major barriers to effective management of the patients.
Conclusion: Most of the causes of paediatric RF in our hospital are preventable. Purposive preventive measures and creation of pediatric nephrology and dialysis units can reduce morbidity and mortality of paediatric RF.
Keywords: Renal failure, children, etiology, comorbidities, dialysis, outcome, Togo
J. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(1) : 11-18
Methods: Consecutive cases of RF admitted from January, 2005 through December, 2007 were prospectively studied. Informations about age, gender, body surface area, urine volume per day, early or late presentation, clinical features, aetiology, comorbidities, dialysis need, laboratory investigations, admission duration and outcome in each patient were obtained.
Results: Out of 14468 children admitted in the study period 92 (0.63%) presented RF. There were 50 boys and 42 girls (sex ratio: 1.19); mean age was 6.30 ± 5 years. Most of the patients (80.44%) presented late, at least 1 week after renal failure onset. Acute (80.43%) or chronic (19.57%), Oliguric (45.65%), nonoliguric (36.95%) and anuric (17.39%) RF were the identified clinical types. Dialysis requirement concerned 50 patients (54.34%) of whom oliguric (68%) and anuric (32%) RF cases, but only 20% of them were dialyzed. Primary and secondary aetiologies accounted for 39.13% and 60.87% of RF respectively. Nephrotic syndrome (17.39%) and glomerulonephritis (6.52%) were the major primary etiologies. Of acute RF. Plasmodium falciparum malaria (21.73%) and septicaemia (15.21%) were the major secondary aetiologies. Anaemia was present in all patients and was the most frequent comorbidity. It occurred alone (23.91%) or in combination with other comorbidities (76.08%). Late presentation of the patients (80.44%), nondialysis (80%), primary etiology (39.13%) and presence of more than one comorbidities (76.08%) correlated significantly with mortality. Overall mortality rate was 47.82%. Financial constraints on the part of parents of patients, lack of dialysis and paediatric nephrology units were major barriers to effective management of the patients.
Conclusion: Most of the causes of paediatric RF in our hospital are preventable. Purposive preventive measures and creation of pediatric nephrology and dialysis units can reduce morbidity and mortality of paediatric RF.
Keywords: Renal failure, children, etiology, comorbidities, dialysis, outcome, Togo
J. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(1) : 11-18
