Published online Mar 6, 2016. doi: 10.5527/wjn.v5.i2.213
Peer-review started: June 10, 2015
First decision: September 17, 2015
Revised: December 9, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: March 6, 2016
AIM: To determine epidemiology of Bruneian paediatric chronic kidney disease (CKD) patients and factors that affect growth and progression of disease.
METHODS: A cross-sectional study conducted on all children below 18 years old who were diagnosed with CKD over a ten year period (2004 to 2013). The reference population was all children (< 18 years old) suffering from CKD and attending the tertiary paediatric nephrology clinic in Brunei Darussalam. Demographic (current age, age of diagnosis, gender, ethnicity), anthropometric (weight and height), diagnosis, laboratory data (serum creatinine and haemoglobin, urinalysis) and blood pressure were extracted from the patients’ clinical case notes and recorded using a data collection form.
RESULTS: The study revealed a high national prevalence [736 per million child population (pmcp)] and incidence (91 pcmp) of CKD. If CKD was defined at Stage 1, 2, 3, 4 or 5, the associated prevalence figures were 736, 132, 83, 50 and 33 pmcp. Glomerulonephritis accounted for 69% of all prevalent cases, followed by congenital abnormalities of kidney and urinary tract (20%) and tubulointerstitial diseases (8%). Minimal change disease being the most common histological diagnosis. The median age of diagnosis was 4.5 years, with congenital disease patients experiencing an earlier onset of diagnosis. A large proportion of patients were below the 5% percentile for height and weight. Non-glomerular diseases, adolescent and female patients were significantly associated with poor growth, but not glomerular filtration rate, age of diagnosis or steroid usage.
CONCLUSION: Brunei has a high prevalence of chronic kidney disease in the paediatric population with glomerulonephritis being the most common disease.
Core tip: This study provides demographic data for chronic kidney disease (CKD) in children and adolescents in Brunei Darussalam. Due to the small population, referral pattern and healthcare infrastructure of the country, the authors believe that the research has enabled a closer estimate of national prevalence and incidence of all stages of CKD than most countries. To our knowledge, this study is the first of its kind to report on epidemiology of CKD from the earliest stages.