ESPN 51th Annual Meeting

ESPN 2018


 
End Stage Renal Disease in pediatric population in a southern area of algeria
MESSAOUD HADJ MAHAMMED 1

1- DR TIRICHINE BRAHIM HOSPITAL, GHARDAIA
 
Introduction:

 End stage renal disease (ESRD) in pediatric population is a major challenge for medical and paramedical staff

In Algeria, the number of children reaching ESRD increases annually. Epidemiological studies of the pediatric ESRD in Algeria are few. The statistical data are collected but there is no operable national register.

The objectives of this study are to:

•Estimate the prevalence and the annual incidence of ESRD in the pediatric population of Ghardaïa.

•Determine the epidemiological characteristics of dialyzed children

•Analyze the results of pediatric dialysis during the period of the study

Material and methods:

 In this retrospective study, we included all patients under the age of 19 years at the time of the ESRD, living in Ghardaïa, treated at least 03 months by hemodialysis (HD) or peritoneal dialysis (DP) during the period between 01/01/2005 to 12/31/2018.

Information was collected from the medical files, interrogation of patients and their parents.

Results:

 Thirty (30) children under the age of 19 years have reached the ESRD. The average age was 12 years (1-19), sex ratio (M / F) was 0.9 (14/16).

The average annual incidence of pESRD in our series was: 12 pmarp / yr.

The prevalence is : 135 pmarp. (Per million age related population)

The frequency was high for patients between 10 and 14 years of age (44%), there is no difference in numbers between the two sexes.

Congenital abnormalities of kidneys and urinary tract (CAKUT) and hereditary nephropathies was the first cause of ESRD in our study (27 % each) Followed by primary Glomerular nephropathy (23 %), cortico-resistant nephrotic syndrome was the chief of wire.

In 23 % of the cases, the etiology was not found; this is mainly due to delayed diagnosis

Hemodialysis is the first treatment method for incident (76%) and prevalent (70%) patients .It was in most cases urgent (68%), anemia was predominantly present at the time of dialysis ( 88%).  

A very high mortality rate (33 %) was founded mainly due to dialysis insufficiency,

A very low school enrollment (40%) and significant retardation of growth (60%).

None of our patients was regularly followed in pediatrics during years of dialysis

 

The transplant rate (3 %) is very low, only 1 patient has been transplanted, obstacles to kidney transplantation are numerous, mainly the absence of donor (58%) or the nature of the initial nephropathy

Conclusions:

 Our study is the first work on pediatric IRCT in southern Algeria; we were able to raise the following remarks:

- Very high incidence and prevalence of pediatric ESRD compared to Europe or the USA

- Delayed diagnosis of chronic kidney disease detrimental to patient survival

- Absence of targeted prevention or screening programs

- Very limited access to specialized therapies (urological surgery, genetic tests)

A comprehensive, planned and multidisciplinary care of the dialysis child should ensure acceptable growth, good schooling and a better quality of life

It requires good training of health professionals and close collaboration between the different practitioners in charge of the dialysis child.