Study of Chronic Renal Failure in Children

Abstract

Introduction: Chronic kidney disease (CKD) is not uncommon in children. It constitutes a major public health problem for both poor and developed countries. The objective of this study was to describe the sociodemographic, clinical, and prognostic profile of CKD in children to contribute to the improvement of its management. Methodology: This was a retrospective, descriptive study conducted from January 2020 to December 2024 in the pediatric departments of the CHU-ME and CHU-R. All patients aged between 3 months to 15 years admitted for CKD were included. The variables studied were sociodemographic, clinical, paraclinical and evolutionary. Results: During the study period, 42,123 pediatric patients were admitted. Of these, 50 met the inclusion criteria for CKD, resulting in a hospital prevalence of 0.11%. The mean age was 10.3 years with extremes being 3 months and 15 years. Males constituted 56% (n = 28) of the cohort, with a sex ratio of 1.3. The most common clinical presentations were proteinuria, detected on urine dipstick in 94% (n = 47) of cases, and edema of the lower limbs (78%, n = 39). All patients (100%) presented with anemia. A majority of patients (70%, n = 35) were in stage 5 CKD, according to KDIGO guidelines. Hemodialysis was required for 58% (n = 29) of patients, often due to complications such as uremic coma. The overall mortality rate was 42% (n = 21), with deaths primarily attributed to cardiorespiratory complications. Conclusion: The prevalence of chronic renal failure in children is low (0.11%). The clinical picture is dominated by proteinuria and peripheral edema. Chronic glomerulonephritis represented the most frequent etiologies. Hemodialysis is the only therapeutic option. Overall mortality remains high.