Causes of renal disease among study participants.

Introduction
Paediatric nephropathy, a condition associated with significant morbidity and mortality, is increasing in developing countries. Data on children with renal diseases are insufficient in Ghana despite the risk it poses. This study assessed the pattern, spectrum, outcome, and predictors of dialysis and death among children with renal disease at Korle Bu Teaching Hospital (KBTH), Ghana.
Materials and methods
A cross-sectional retrospective review was conducted among children aged 0–17 years. Demographic characteristics, clinical and laboratory data, information on dialysis and treatment outcomes were obtained from their medical records and analyzed accordingly using STATA software version 15.1.
Results
A total of 332 children with renal diseases were seen (median age of 6 years), with 200(60.98%) being males. The most common renal diseases were nephrotic syndrome 141(42.47%) and acute kidney injury (AKI) 87(26.20%). Idiopathic (unknown) causes (82.98%) and intravascular hemolysis secondary to malaria (41.38%) were the major causes of nephrotic syndrome and acute kidney injury respectively. A death rate of 15.06% resulting mostly from AKI (6.33%) was observed whilst 7.83% underwent dialysis. Predictors of dialysis among those who had dialysis included being a female and having acute on chronic kidney disease whilst having high white blood cell count and acute on chronic kidney disease were significant predictors of death among children with renal diseases.
Conclusion
Paediatric renal diseases at KBTH were dominated by nephrotic syndrome and AKI. Timely treatment and prevention of common infectious agents and conditions causing intravascular hemolysis, which can contribute to paediatric renal diseases in Ghana, is needed to help reduce their progression to various forms of kidney disease.

引言
小儿肾病（Paediatric nephropathy）是一种伴随较高发病率与死亡率的疾病，在发展中国家的发病率呈上升趋势。尽管加纳存在该病的发病风险，但该国针对儿童肾脏疾病的相关数据仍较为匮乏。本研究针对加纳科莱布教学医院（Korle Bu Teaching Hospital, KBTH）收治的儿童肾脏疾病患者，评估了其疾病类型、疾病谱、治疗结局，以及透析与死亡的预测因素。

材料与方法
本研究针对0~17岁儿童开展了一项横断面回顾性研究。研究人员从患者的医疗记录中提取人口统计学特征、临床与实验室检查数据、透析相关信息及治疗结局数据，并采用STATA 15.1版软件进行数据分析。

结果
本研究共纳入332例儿童肾脏疾病患者，中位年龄为6岁，其中男性200例（占比60.98%）。最常见的肾脏疾病为肾病综合征（141例，占比42.47%）与急性肾损伤（acute kidney injury, AKI，87例，占比26.20%）。肾病综合征的主要病因为特发性（病因不明）病因（占比82.98%），急性肾损伤的主要诱因为继发于疟疾的血管内溶血（占比41.38%）。研究期间患者总死亡率为15.06%，其中多数死亡与AKI相关（占总患者的6.33%）；另有7.83%的患者接受了透析治疗。在接受透析的患者中，女性性别与慢性肾脏病基础上急性发作是透析的显著预测因素；而白细胞计数升高与慢性肾脏病基础上急性发作则是儿童肾脏疾病患者死亡的独立预测因素。

结论
科莱布教学医院收治的小儿肾脏疾病以肾病综合征与AKI为主。为减缓加纳儿童肾脏疾病的进展，亟需对可引发血管内溶血的常见病原体及相关病症开展及时治疗与预防。