Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil
Abstract Objective: To describe the characteristics of stage-5 chronic kidney disease (CKD) children and adolescents undergoing renal replacement therapy (RRT) in Amazonas, Brazil, estimating the frequencies of current and new cases, describing the presence of anemia and bone metabolism disorders....
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| Format: | Article |
| Language: | English |
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Sociedade de Pediatria de São Paulo
2022-04-01
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| Series: | Revista Paulista de Pediatria |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100430&tlng=en |
| _version_ | 1818354337689108480 |
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| author | Ana Matilde Menezes Melik Schramm Inalda Facincani Fabio Carmona |
| author_facet | Ana Matilde Menezes Melik Schramm Inalda Facincani Fabio Carmona |
| author_sort | Ana Matilde Menezes Melik Schramm |
| collection | DOAJ |
| description | Abstract Objective: To describe the characteristics of stage-5 chronic kidney disease (CKD) children and adolescents undergoing renal replacement therapy (RRT) in Amazonas, Brazil, estimating the frequencies of current and new cases, describing the presence of anemia and bone metabolism disorders. Methods: Thirty-five patients aged 7 to 19 years-old on hemodialysis (HD) or peritoneal dialysis (PD) were studied between June 2018 and April 2019. The frequencies of current and new cases were estimated based on the 0 to 19 years-old population of Amazonas, in the same period. Data were collected about the underlying cause and diagnosis of CKD, dialysis, and biochemical analysis. Results: The frequencies of current and new cases were 24 and 15 patients per million people of compatible age (pmpca), respectively. The causes of CKD were nephrotic syndrome (22.8%), nephritic syndrome (14.3%), and neurogenic bladder (14.3%); in 48.6%, the cause was unknown/not investigated. Ten patients underwent renal biopsy, seven with segmental and focal glomerulosclerosis. The majority (80%) were on HD, with an average kt/V of 1.4, and in 51.4% the vascular access was the double lumen catheter. Hypocalcemia was found in 82.8% of patients, hyperphosphatemia in 57.2%, vitamin D insufficiency or deficiency in 60%, and altered parathyroid hormone values in 48.6%. Hemoglobin was low in 80%, with absolute/functional iron deficiency in 28.6%. Conclusions: In children and adolescents of Amazonas, Brazil, we found 24 pmpca with stage-5 CKU currently in RRT and 16.3 pmpca per year of new cases requiring RRT. Most patients were adolescents on HD, half without a causal diagnosis of CKD, with a high frequency of anemia and bone metabolism disorder. |
| first_indexed | 2024-12-13T19:23:49Z |
| format | Article |
| id | doaj.art-60b4eecf53364bf3a952c9270b5169a6 |
| institution | Directory Open Access Journal |
| issn | 1984-0462 |
| language | English |
| last_indexed | 2024-12-13T19:23:49Z |
| publishDate | 2022-04-01 |
| publisher | Sociedade de Pediatria de São Paulo |
| record_format | Article |
| series | Revista Paulista de Pediatria |
| spelling | doaj.art-60b4eecf53364bf3a952c9270b5169a62022-12-21T23:34:06ZengSociedade de Pediatria de São PauloRevista Paulista de Pediatria1984-04622022-04-014010.1590/1984-0462/2022/40/2021057Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, BrazilAna Matilde Menezes Melik Schrammhttps://orcid.org/0000-0001-9258-5808Inalda Facincanihttps://orcid.org/0000-0002-2259-2073Fabio Carmonahttps://orcid.org/0000-0001-5743-0325Abstract Objective: To describe the characteristics of stage-5 chronic kidney disease (CKD) children and adolescents undergoing renal replacement therapy (RRT) in Amazonas, Brazil, estimating the frequencies of current and new cases, describing the presence of anemia and bone metabolism disorders. Methods: Thirty-five patients aged 7 to 19 years-old on hemodialysis (HD) or peritoneal dialysis (PD) were studied between June 2018 and April 2019. The frequencies of current and new cases were estimated based on the 0 to 19 years-old population of Amazonas, in the same period. Data were collected about the underlying cause and diagnosis of CKD, dialysis, and biochemical analysis. Results: The frequencies of current and new cases were 24 and 15 patients per million people of compatible age (pmpca), respectively. The causes of CKD were nephrotic syndrome (22.8%), nephritic syndrome (14.3%), and neurogenic bladder (14.3%); in 48.6%, the cause was unknown/not investigated. Ten patients underwent renal biopsy, seven with segmental and focal glomerulosclerosis. The majority (80%) were on HD, with an average kt/V of 1.4, and in 51.4% the vascular access was the double lumen catheter. Hypocalcemia was found in 82.8% of patients, hyperphosphatemia in 57.2%, vitamin D insufficiency or deficiency in 60%, and altered parathyroid hormone values in 48.6%. Hemoglobin was low in 80%, with absolute/functional iron deficiency in 28.6%. Conclusions: In children and adolescents of Amazonas, Brazil, we found 24 pmpca with stage-5 CKU currently in RRT and 16.3 pmpca per year of new cases requiring RRT. Most patients were adolescents on HD, half without a causal diagnosis of CKD, with a high frequency of anemia and bone metabolism disorder.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100430&tlng=enChronic kidney diseaseRenal replacement therapyChildrenAmazon |
| spellingShingle | Ana Matilde Menezes Melik Schramm Inalda Facincani Fabio Carmona Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil Revista Paulista de Pediatria Chronic kidney disease Renal replacement therapy Children Amazon |
| title | Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil |
| title_full | Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil |
| title_fullStr | Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil |
| title_full_unstemmed | Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil |
| title_short | Evaluation of renal replacement therapy in children and adolescents in the state of Amazonas, Brazil |
| title_sort | evaluation of renal replacement therapy in children and adolescents in the state of amazonas brazil |
| topic | Chronic kidney disease Renal replacement therapy Children Amazon |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100430&tlng=en |
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