Clinical Characteristics and Outcome of Children Requiring First-Time Hemodialysis Over a Year: A Tertiary Center Cohort Study.

Document Type : Original Article

Authors

1 department of pediatrics, Faculty of medicine, Cairo university

2 Department of Pediatrics, Faculty of Medicine, Cairo University

3 Department of Pediatrics ,Kasralainy faculty of medicine ,Cairo university

Abstract

Introduction: Acute kidney injury (AKI)and chronic kidney disease (CKD) are serious morbid illnesses with increasing prevalence. Renal replacement therapy is often necessary when kidney function deteriorates, hemodialysis is the most used renal replacement therapy in developing countries.
Aim of the study: The study aims to review the clinical characteristics and outcomes of patients undergoing the first hemodialysis session in our center over one year.
Methods: This is a cohort longitudinal study that included 97 pediatric patients with kidney failure who underwent the first hemodialysis session.
Results: In total, the mean age was 8.84 ± 3.3 years, 53 (54.6%) were males. 42 (43.3%) were offsprings of consanguineous parents and 22.7% had a positive family history of CKD. Acute kidney injury affected thirty-four patients (35%) and chronic kidney disease affected sixty- three patients (65%). The primary causes of AKI and CKD were atypical hemolytic uremic syndrome (aHUS) and unknown kidney disease respectively, and the primary indications of HD were volume overload in AKI and uremic manifestation in CKD. Regarding the AKI group, 61.8% improved, 35.3% progressed to CKD, and 2.9% died. Male sex was more predominant among improved cases (71%), while among non-improved cases, aHUS represented 53% of the etiology with a P-value of 0.043 moreover, anemia and metabolic acidosis were significantly detected with P-values of 0.047 and 0.046 respectively as well as cardiovascular risks.
Conclusion: The main etiology of CKD in our center was unknown. The most important predictors of poor prognostic outcomes in AKI were female sex, anemia, metabolic acidosis, and cardiovascular risks.

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