Etiologic-sociodemographic assessment and comparison of dialysis modalities in pediatric Syrian migrants with chronic kidney disease

Abstract

Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the important causes of mortality and morbidity in childhood. Early diagnosis and treatment of the underlying primary disease may prevent most of CKD patients from progressing to ESRD. There is no study examining chronic kidney diseases and dialysis modalities in Syrian immigrant children. We aimed to retrospectively research the etiologic, sociodemographic, and clinical factors in CKD among Syrian refugee children, and at the same time, to compare the clinical characteristics of patients with ESRD on peritoneal dialysis and hemodialysis. Methods: Our study included a total of 79 pediatric Syrian patients aged from 2-16 years monitored at Hatay State Hospital pediatric nephrology clinic with diagnosis of various stages of CKD and with ESRD. Physical-demographic features and clinical-laboratory information were retrospectively screened. Results: The most common cause of CKD was congenital anomalies of the kidneys and urinary tracts (CAKUT) (37.9%). Other causes were urolitiasis (15.1%), nephrotic syndrome (10.1%), spina bifida (8.8%), hemolytic uremic syndrome (7.5%), and glomerulonephritis (7.5%). Twenty-five patients used hemodialysis due to bad living conditions. Only 2 of the patients with peritoneal dialysis were using automatic peritoneal dialysis (APD), with 5 using continuous ambulatory peritoneal dialysis (CAPD). Long-term complications like left ventricle hypertrophy and retinopathy were significantly higher among hemodialysis patients. There was no difference identified between the groups in terms of hypertension and sex. Conclusion: Progression to ESRD due to preventable reasons is very frequent among CKD patients. For more effective use of peritoneal dialysis in pediatric patients, the responsibility of states must be improved.

Mülteci çocukların renal sağlığı: süregelen bir zorluk

“…[12] Multicenter study including data of 633 pediatric refugee children from pediatric nephrology centers in Turkey reported CKD incidence to be 14.8% and CAKUT to be more frequent. [8] Celakıl et al [13] evaluated 79 refugee pediatric patients with end stage renal disease (ESRD) and diagnosis of various stages of CKD and the most common cause was reported to be CAKUT (37.9%). In our presented study the frequency of CKD was determined slightly higher (25.6%), with the leading cause being CAKUT (73.5%).…”

Chronic kidney disease in immigrant children: an emerging clinical-epidemiological scenario in clinical practice

“…The topic addressed by Mehtap Çelakil e Yasemin Çoban (2021) 4 represents a relevant and emerging problem that highlights the importance of population migrations in understanding epidemiological and clinical factors that are important for diagnostic and therapeutic decisions. From the knowledge obtained by studies in Turkey, we can create horizons for research and search for knowledge to understand the immigrant population in Brazil in the last 10 years.…”