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The spectrum of chronic kidney disease (stages 2–5) in KwaZulu-Natal, South Africa

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Abstract

The burden of chronic kidney disease (CKD) in children in developing countries remains unknown, due to the lack of a national data-reporting system. We undertook a retrospective study of all children < 16 years old in our hospital, which is the tertiary referral centre for children with complex kidney disorders, to analyse the spectrum of CKD (stages 2–5) from 1994–2006. Six hundred and fifty-three children with kidney disorders were screened for CKD; 286 (44.0%) were < 5 years old. Of these, 177 (62%) were male, 202 (70.6%) were black, 77 (26.9%) were Indian, five (1.8%) were mixed race and two (0.7%) were white. One hundred and twenty-six children had CKD (stages 2–5); 55 (43.7%) were < 5 years olds; 41 (74.5%) were male. There were 71 (56.3%) that were > 5 years old, 42 (59.2%) were male. The commonest cause of CKD (stages 2–5) in all children was nephrotic syndrome, comprising 30.9% in children < 5 years old and 40.8% in children > 5 years old. Within the observation period of 11 years, end-stage kidney disease was diagnosed in 20 children; only nine had been on long-term dialysis, and seven qualified for transplantation. Five (25%) children had died, four from sepsis during dialysis and one from tuberculosis after receiving a transplant. We concluded that lack of resources, late referrals, and high cost of renal replacement therapy in developing countries leads to poor outcome in CKD.

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Acknowledgements

We wish to thank the Medical Manager of King Edward VIII Hospital for permission to publish, and Ms S. Rambali for her administrative assistance. Professors R. Bhimma and M. Adhikari were supported by grants for this study from the Medical Research Council of South Africa and the National Research Foundation. Ms K. Asharam is supported by grants from the National Kidney Foundation of South Africa and the David Hepburn Trust.

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Authors and Affiliations

  1. Department of Maternal & Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

    Rajendra Bhimma, Miriam Adhikari & Kareshma Asharam

  2. Department of Paediatrics & Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, 4013, South Africa

    Rajendra Bhimma

  3. Medical Research Council of South Africa, Durban, South Africa

    Catherine Connolly

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  1. Rajendra Bhimma
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  2. Miriam Adhikari
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Correspondence to Rajendra Bhimma.

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Bhimma, R., Adhikari, M., Asharam, K. et al. The spectrum of chronic kidney disease (stages 2–5) in KwaZulu-Natal, South Africa. Pediatr Nephrol 23, 1841–1846 (2008). https://doi.org/10.1007/s00467-008-0871-5

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  • DOI: https://doi.org/10.1007/s00467-008-0871-5

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