Prognosis of Chronic End-Stage Renal Failure in Patients under 20 Years of Age in Conakry

Abstract

Introduction: End-stage renal disease (ESRD), requiring purification during Child Hood, is a rare situation and a source of high morbidity and mortality, raising ethical questions. In Guinea, the lack of national registers of pediatric chronic kidney disease, the absence of a nephropediatric service, the treatment of certain pediatric cases of CKD in the adult hemodialysis center, and the consequence on the evolution of children undergoing replacement therapy is not evaluated in terms of survival. We are conducting this study to assess the prognosis of CKD and chronic hemodialysis in patients under 20 years of age. The survival of patients under 20 years of age on chronic hemodialysis in an adult hemodialysis center is considerable. Material and Methods : This is a retrospective study of chronic end-stage renal disease in patients under 20 years of age, who may or may not have received chronic hemodialysis in an adult hemodialysis center. In our study, we included the records of patients under 20 years of age, with a creatinine clearance of less than 15 mL/min/1.73m 2 according to the Schwartz formula, who did or did not accept chronic hemodialysis. Results: out of 724 patients hospitalized with all pathologies during the study period, we obtained 55 patients under 20 years of age with chronic end-stage renal disease, i.e., a frequency of 8 %, representing our study population. The mean age was 13 ± 3 years, with extremes ranging from 9 to 19 years. We found a predominance in the 15 - 19 age group, numbering 49 patients, or 89.09%. Of 55 patients under 20 years of age with chronic end-stage renal failure, 34 patients who had received chronic hemodialysis, only 24 patients (70.59%) were still alive, while 10 patients (29.41%) had died. Conclusion: The aim of this retrospective study on the prognosis of chronic end-stage renal failure in patients under 20 years of age, enabled us to obtain a hospital frequency equal to 8%. The main cause of chronic renal disease was glomerular nephropathy. The death rate was essentially due to the lack of nephropediatric services, and the lack of equipment for suppletive treatment adapted to children.