Pattern of Childhood Renal Disorders in Enugu

Abstract

A prospective study of children with renal disorders was undertaken over a 13-year period. There were 854 patients, aged between birth and 16 years and of these, males constituted 65.1 percent. Children with renal disorders constituted four percent of all paediatric admissions over the period. The commonest five disorders in our series were nephrotic syndrome (40.5 percent), acute glomerulonephritis (31.9 percent), renal failure (acute and chronic 10.1 percent), urinary tract infection (5.6 percent) and nephroblastoma (4.9 percent). These five disorders constituted 93.0 percent of all childhood renal disorders. Less common disorders included obstructive uropathy, sickle-cell nephropathy, renal hypertension, nephrogenic diabetes insipidus, enuresis, neurogenic bladder and benign isolated haematuria. Among those with nephrotic syndrome, there was a remission rate of 64 percent, using various combinations of therapeutic regimes including pooled plasma, diuretics, prednisolone and cyclophosphamide. Acute glomerulonephritis which was preceded mostly by pyoderma rather than by pharyngitis, was associated with a very good prognosis. Urinary tract infection was probably underdiagnosed, with some radiologically documented cases of renal scarring, but no vesico-ureteric reflux. Besides sickle-cell nephropathy, there were no cases of inherited, metabolic or genetic disorders, possibly due to the prevalent cultural practice of non- consanguinous marriages.