POS-824 PATTERN OF RENAL DISEASES IN THE PAEDIATRIC RENAL CLINIC, KORLE BU TEACHING HOSPITAL

Abstract

The pattern of kidney diseases among paediatric patients may differ globally due to environmental and inherited factors. The Paediatric Renal Clinic, Korle Bu Teaching Hospital, is a major referral clinic for children with renal diseases in the southern part of Ghana. There is no published data on the pattern of diseases seen in this clinic. Our objective was to determine the pattern of renal diseases seen at the Paediatric Renal Clinic of Korle Bu Teaching Hospital. In this retrospective study, we reviewed the data of all patients registered at the Paediatric Renal Clinic of Korle Bu Teaching Hospital from April 2017 to April 2019. The data was analyzed using SPSS© version 24. 226 patients were registered during the period. Mean age was 6.6 years ± 3.8 years [range 2 weeks to 19 years], with a male predominance (62.8% male, 32.7% female). M:F ratio was 1.7:1. The pattern was NS -148(65.5%); CAKUT -29(12.8%); AGN-25(11.1%); AKI-12(5.3%); CKD -7(3.1%) and others- 5(2.2%). The male predominance is higher among patients with AGN (M: F = 2.5:1) and NS (M: F = 1.8:1). Concerning steroid response among patients with NS, 123 (83.1%) were steroid sensitive, 13(8.6%) were steroid dependent, 11(7.9%) were steroid resistant while 1(0.7%) was frequently relapsing. NS response to steroids was not associated with gender (p= 0.237). Multicystic dysplastic kidney disease was the commonest CAKUT accounting for 31% of all CAKUT. The high steroid sensitivity in our study population could be explained by the close monitoring and follow-up of patients that happen in our clinic. It probably reflects the decreasing burden of some of the viral aetiologies of NS, especially as our immunization coverage increases. It could also be due to undetermined genetic factors. The commonest diagnoses in our paediatric renal clinic during the study period were NS, CAKUT and AGN. As NS is a chronic relapsing and remitting disease requiring multidisciplinary management, there is the need to include a comprehensive service in the renal clinic. Our study population showed high steroid sensitivity among patients with NS. Therefore, it is recommended that whenever a patient does not show steroid sensitivity, he/she should be closely monitored to exclude non-adherence to therapy