الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Kidney diseases are major causes of morbidity and mortality. Pediatric patients especially younger ones with kidney disease may present with nonspecific signs and symptoms unrelated to the urinary tract. Pediatricians, therefore, should be familiar with the modes of presentation of different kidney conditions and should have a high index of suspicion of kidney disease. Early diagnosis and treatment of kidney disease in children is important in the prevention of kidney failure and end-stage renal disease (ESRD).
This study was performed with the aim of describing the current spectrum of pediatric nephrology diseases in Alexandria University Children`s Hospital.
A 6 months study of pediatric kidney admissions was carried out and the overall percentage, disease-specific mortality and/or morbidity rates was determined.
This study was conducted on children with kidney disease who were admitted to inpatient units of Alexandria University Children`s Hospital in 6 months from July 2017 to December 2017.There were (55.7%) male patients, while (44.3%) patients were females with male/female ratio 1.3:1.Their mean age was 5.85 ± 3.88 years, with a range of 0.10 – 16.0 years.
The prevalence rate of kidney admissions in the inpatient units of AUCH in 6 months from July 2017 to December 2017 was(15.9%) which was relatively high.
According to types of kidney diagnoses during hospital admissions. UTI was the commonest kidney diagnosis accounting for 30.4%. The majority of UTI cases were detected in association with other underlying kidney diseases. Nephrotic syndrome (NS) was the second common diagnosis accounting for 18.8% of cases. While acute kidney injury (AKI) and chronic kidney disease (CKD) were in lower rates (6.9% , 18.8%), respectively.
According to the outcome of the cases, (1.3%) died from various causes such as AKI, CKD, and congenital NS. sepsis, electrolytes disturbance, were among factors contributing to mortality.
In this study, there was a significant difference between diagnoses of renal admissions and their different outcomes. In patients who suffered from UTI, about 86.6% of them improved without any deaths while in CKD, end stage kidney disease, acute on top of chronic, SLE, distal renal tubular acidosis and a typical HUS, showed imrprovment of presentations which caused admission as hypertension , generalized edema and electrolyte disturbances ,and they were on follow up due to their chronic outcomes. According to causes of death among diagnoses about half of deaths caused by AKI. Other causes of death were congenital nephrotic syndrome, ESRD and acute kidney injury on top chronic kidney disease.
In this study, there was a significant difference in the duration of admission between patients as regard the different presentation complains (p <0.001).The longest durations of non-renal presentations were convulsion and DLC acconting for(8.43 ± 3.69),( 8.38 ± 6.52)days respectively. The least durations of admissions were arthralgia and carpopedal spasm about(3.83 ± 3.52),( 3.80 ± 2.53)days respecively. The longest durations of of renal presentations were polyuria and nocturnal enuresis about (8.09 ± 4.96),( 7.02 ± 4.14) days, but anuria was the shortest presentation accounting for(4.08 ± 4.75)days.
In this study, there was a significant difference in the duration of admission between patients as regard the different diagnosis (p <0.001). patients who diagnosed as typical HUS and bartter syndrome had the longest duration of admission accounting for (11.6 ±6.8) , (11.5 ± 12.02) days respectively. Patients who were diagnosed with IgA nephropathy and UTI had the shortest duration of admission accounting for (4.39±4.12) (3± 2.87) days respectively.
In this study, there was a significant difference in the frequency of ’ admission between patients as regard the different diagnosis (p <0.001). patients who diagnosed as end stage kidney disease and SLE had the highest frequency of admission accounting for (3.16 ± 3.1) ,(2.8 ±2.14) days respectively. Patients who were diagnosed with renal abscess and bartter syndrome had the lowest frequency of admissions about (1.0 ± 0.0).