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Background <p>The epidemiology and outcome of chronic kidney disease (CKD) in children of less resourced countries are largely underreported.</p> Methods <p>A retrospective follow-up study of children 2 to 14 years old with CKD stage 3 to 5 at Chris Hani Baragwanath Academic Hospital (CHBAH), South Africa, from 2000 to 2019.</p> Results <p>One hundred and ninety-eight children were analysed. Sixty-five (32.8%), 47 (23.7%), and 86 (43.4%) had CKD stages 3, 4 and 5 at diagnosis, respectively. The median (inter quartile range (IQR) age at diagnosis was 7 (4–11) years and duration of follow up was 1.2 (0.3–3.2) years. The calculated annual incidence in 2001 to 2019 ranged from 9.3 to 29.7 per million age-related population (PMARP). Overall, glomerular disease accounted for 74 (37%); congenital anomalies of the kidney and urinary tract (CAKUT) for 64 (32%). At final outcome, 108 children had CKD stage 5. Seventy-three (67.5%) received kidney replacement therapy (KRT) and 35 (32.4%) treated conservatively. The mean rate of decline in eGFR from baseline to final visit was 4.90 (SD 7.03) ml/min/BSA per year. The mortality rate was 9.8 (95%CI:7.3 to 13.1) per 100 person-years (PY), contributed by 46 (23.3%) children. The two-year survival for glomerular disease was 50% compared to 90% for CAKUT. Risk of mortality increased in CKD stage 5 (AHR = 4.1; 95%CI:1.9–8.9, p-value &lt; 0.001), hypoalbuminemia (AHR = 2.7; 95%CI:1.3–5.6, p-value 0.007) and glomerular disease (AHR = 2.2; 95%CI:1.0-4.8, p-value 0.048).</p> Conclusion <p>This cohort presented in chronic kidney failure. Barriers to access of kidney services need to be addressed to achieve sustainable developmental goals (SDG).</p>

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Chronic kidney disease (stages 3–5) in children at Chris Hani Baragwanath Academic Hospital, 2000–2019

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  • 发表日期：

    2026年1月8日

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  • Nokukhanya Ngubane-Mwandla,
  • Shannon Leahy,
  • Nilesh Lala,
  • Zvifadzo Matsena-Zingoni,
  • Karen L. Petersen

摘要

Background

The epidemiology and outcome of chronic kidney disease (CKD) in children of less resourced countries are largely underreported.

Methods

A retrospective follow-up study of children 2 to 14 years old with CKD stage 3 to 5 at Chris Hani Baragwanath Academic Hospital (CHBAH), South Africa, from 2000 to 2019.

Results

One hundred and ninety-eight children were analysed. Sixty-five (32.8%), 47 (23.7%), and 86 (43.4%) had CKD stages 3, 4 and 5 at diagnosis, respectively. The median (inter quartile range (IQR) age at diagnosis was 7 (4–11) years and duration of follow up was 1.2 (0.3–3.2) years. The calculated annual incidence in 2001 to 2019 ranged from 9.3 to 29.7 per million age-related population (PMARP). Overall, glomerular disease accounted for 74 (37%); congenital anomalies of the kidney and urinary tract (CAKUT) for 64 (32%). At final outcome, 108 children had CKD stage 5. Seventy-three (67.5%) received kidney replacement therapy (KRT) and 35 (32.4%) treated conservatively. The mean rate of decline in eGFR from baseline to final visit was 4.90 (SD 7.03) ml/min/BSA per year. The mortality rate was 9.8 (95%CI:7.3 to 13.1) per 100 person-years (PY), contributed by 46 (23.3%) children. The two-year survival for glomerular disease was 50% compared to 90% for CAKUT. Risk of mortality increased in CKD stage 5 (AHR = 4.1; 95%CI:1.9–8.9, p-value < 0.001), hypoalbuminemia (AHR = 2.7; 95%CI:1.3–5.6, p-value 0.007) and glomerular disease (AHR = 2.2; 95%CI:1.0-4.8, p-value 0.048).

Conclusion

This cohort presented in chronic kidney failure. Barriers to access of kidney services need to be addressed to achieve sustainable developmental goals (SDG).