Abstract:

Background: Renal dysfunction in children remains a major health problem in the Sub Saharan Africa and is common among children in Tanzania. However, little is known about prevalence, predictors and outcome of renal dysfunction in children admitted to hospitals in Tanzania.

Objective: To determine the prevalence, predictors and outcomes of renal dysfunction in children admitted at Bugando Medical Centre and Sekou-Toure hospital.

Methodology: This was a hospital based cross-sectional study for determining prevalence of renal dysfunction and its associated factors, with a prospective follow up component (for determining outcome), done among children admitted to the pediatric wards of Bugando Medical Centre and Sekou Toure hospitals. Information on socio-demographic matters and medical history was obtained from the caretaker. Dipstick urinalysis on admission for determining proteinuria and hematuria, together with albuminuria at three months were performed after obtaining a fresh urine sample. Blood sample was obtained for determining serum creatinine on admission and at three months. Estimated glomerular filtration rate was calculated using modified Schwartz equation. Data analysis was done using STATA version 13.

Results: A Total of 513 children were enrolled in the study, of which 83 (16.2%) met the criteria of renal dysfunction. Out of these, 64 were available for follow up at the end of three months, where 15 (23.4%) of those with renal dysfunction had chronic kidney disease. Factors associated with renal dysfunction were herbal medications use (p=0.007), history of sore throat/skin infection (p= 0.024), having sickle cell disease (p= 0.006), dehydration (p=0.001), malaria (p= 0.01), and proteinuria (p= <0.001). There was an association between in hospital mortality and renal dysfunction (p=<0.001).

Conclusion: In our study, high prevalence of renal disease was observed among children admitted to pediatric wards in Mwanza and is associated with high in hospital mortality. Children with renal dysfunction recover their renal function. Screening for renal disease should be performed on all children admitted to hospitals in Tanzania, particularly for children with a history of herbal medication use, sore throat/skin infection, sickle cell disease, dehydration and malaria. If creatinine measurement is not possible, screening for proteinuria is a reasonable alternative.