Pattern of Referral and outcome of Childhood Nephro-urologic Disorders: A 6-year-follow up report in a single Centre in Khartoum

Abstract

Background:  previous patterns and outcomes of nephro-urologic disorders in children in Khartoum might have been influenced by establishment of tertiary care renal services. The aim of this study was to re-study these parameters to determine if any changes towards improvement of child healthcare have occurred. Methods: We retrospectively reviewed case records of all children with renal disorders who were referred to the paediatric nephrology unit, Soba University Hospital, Khartoum, during the period January 2006 to December 2012. Results: A total of 800 children with 1121 renal disorders were seen forming 5.5% of the paediatric unit cases ; 61% males and 38.8% females . Mean age at diagnoses was 7.73 years (±5.35) .Common causes of renal disorders were chronic kidney disease (24.1%), acute glomerulonephritis (14.9%) and nephrotic syndrome (14.8%) followed by urinary tract infections (11.3%) and acute kidney injury (10.5%).  Renal calculi, hereditary diseases, congenital anomalies of kidney and urinary tract, multisystem diseases and renal tumors were: recorded in 7.7%, 7.6%, 5.1%, 3.1%, and 0.8% respectively. On short term follow-up 59.2% recovered renal function, 22% progressed to CKD, 6.2% died, 5% referred to other centers and 7.5% were lost to follow-up. Conclusion: Glomerular diseases and CKD were the most common causes of referral of children with nephro-urologic disorders in Sudan. These findings reflect the referral pattern in a centre where tertiary care paediatric renal services are developing and patient care is improving. The high prevalence of CKD with a potentially treatable causes calls for more efforts to early detect and refer CKD patients.