Predictors of dialysis and death among paediatric renal disease patients: A 14-year retrospective study at Korle Bu Teaching Hospital, Ghana.
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Introduction: : Paediatric nephropathy, a condition associated with significant morbidity and mortality, is increasing in developing countries. Data on paediatric 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 paediatric renal disease patients at Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Method: ology : Among children aged 0-17 years on admission at the Child Health Department of KBTH, a retrospective hospital-based study was conducted. Demographic characteristics, clinical data including type, cause, duration, and symptoms of renal diseases, laboratory data (haemtological and biochemical), information on dialysis and treatment outcome were obtained from their records. Data were analyzed accordingly using STATA software version 15.1. Results: : A total of 353 children with renal diseases were seen during the study period (2009-2022) (mean age of 5.91 ±3.99), with 217(62.18%) being males. The most common renal diseases were nephrotic syndrome 141(39.94%), acute kidney injury (AKI) 87(24.65%) and acute glomerulonephritis 47(13.31%). Others included polycystic kidney disease (0.85%), lupus nephritis (0.57%), and others (ureterostomies, bladder calculus, and dilated ectopic renal pelvis)(1.70%). Idiopathic causes (26.35%) were the major cause of renal diseases followed by intravascular haemolysis (20.11%), infection (18.70%), and hypertension (17.00%). Swelling (76.88%), facial puffiness (39.02%), fever (34.97%), and abdominal distension (24.57%) were the most common symptoms. A death prevalence of 16.43% resulting mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%) was observed at KBTH whilst 7.37% were on dialysis. Predictors of dialysis included female gender, high urea levels and acute on chronic kidney disease whilst being admitted for a month or less and more than 5 years, high white blood cell count (WBC), acute on chronic kidney disease, and renal impairment were significant predictors of death among children with renal diseases. Conclusion: : Paediatric renal diseases at KBTH were dominated by nephrotic syndrome and AKI. High WBC count, acute on chronic kidney disease, and renal impairment were significantly associated with death among children with renal diseases. Therefore, much attention should be paid to these parameters during their care.
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Predictors of dialysis and death among paediatric renal disease patients: A 14-year retrospective study at Korle Bu Teaching Hospital, Ghana. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Predictors of dialysis and death among paediatric renal disease patients: A 14-year retrospective study at Korle Bu Teaching Hospital, Ghana. George Nkrumah Osei, Emmanuel Worae, Betty Effie Adoko Ghartey, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2582884/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Paediatric nephropathy, a condition associated with significant morbidity and mortality, is increasing in developing countries. Data on paediatric 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 paediatric renal disease patients at Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Methodology : Among children aged 0-17 years on admission at the Child Health Department of KBTH, a retrospective hospital-based study was conducted. Demographic characteristics, clinical data including type, cause, duration, and symptoms of renal diseases, laboratory data (haemtological and biochemical), information on dialysis and treatment outcome were obtained from their records. Data were analyzed accordingly using STATA software version 15.1. Results : A total of 353 children with renal diseases were seen during the study period (2009-2022) (mean age of 5.91 ±3.99), with 217(62.18%) being males. The most common renal diseases were nephrotic syndrome 141(39.94%), acute kidney injury (AKI) 87(24.65%) and acute glomerulonephritis 47(13.31%). Others included polycystic kidney disease (0.85%), lupus nephritis (0.57%), and others (ureterostomies, bladder calculus, and dilated ectopic renal pelvis)(1.70%). Idiopathic causes (26.35%) were the major cause of renal diseases followed by intravascular haemolysis (20.11%), infection (18.70%), and hypertension (17.00%). Swelling (76.88%), facial puffiness (39.02%), fever (34.97%), and abdominal distension (24.57%) were the most common symptoms. A death prevalence of 16.43% resulting mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%) was observed at KBTH whilst 7.37% were on dialysis. Predictors of dialysis included female gender, high urea levels and acute on chronic kidney disease whilst being admitted for a month or less and more than 5 years, high white blood cell count (WBC), acute on chronic kidney disease, and renal impairment were significant predictors of death among children with renal diseases. Conclusion : Paediatric renal diseases at KBTH were dominated by nephrotic syndrome and AKI. High WBC count, acute on chronic kidney disease, and renal impairment were significantly associated with death among children with renal diseases. Therefore, much attention should be paid to these parameters during their care. Health sciences/Medical research Health sciences/Nephrology Predictors renal disease Ghana children Introduction Paediatric nephrology is not the first concern in developing countries contrary to developed countries in relation to its preventive and curative measures (Cochat et al., 2009 ). This is partly due to inadequate data on paediatric renal diseases and a focus on communicable diseases in developing countries (Ladapo et al., 2014 ). Data from hospital-based studies have reported the burden of paediatric renal diseases in developing countries, with the prevalence of 2.2%, 3.3%, 6.9%, and 8.9% observed in Nigeria, Ethiopia, Nepal, and Nigeria respectively (Anigilaje & Adesina, 2019 ; Ibeneme et al, 2015 ; Mola Kebede & Damte, 2016; Yadav et al., 2016 ). This reveals that renal diseases are common among children in Nigeria, Ethiopia, and possibly other developing countries. Acute kidney injury (AKI), nephrotic syndrome (NS), acute glomerulonephritis (AGN), and urinary tract infection (UTI) are the most reported paediatric renal diseases in sub-Saharan Africa (Adedoyin et al., 2012 ; Anigilaje & Adesina, 2019 ; Antwi et al., 2015 ; Derakhshan et al., 2004 ; Mola Kebede & Damte, 2016; Obiagwu et al, 2019 ; Ocheke et al., 2010 ; Wordui, 2021 ; Yadav et al., 2016 ). However, the prevalence of CKD remains low in sub-Saharan Africa (Anigilaje & Adesina, 2019 ; Derakhshan et al., 2004 ; Mola Kebede & Damte, 2016; Obiagwu et al, 2019 ; Onifade, 2003 ; Wordui, 2021 ). Aetiology of paediatric renal diseases varies widely according to the clinical setting, geographical region, and age (Antwi et al., 2015 ). Infection, sepsis, hypertension, diarrhoea, severe malaria and herbal concoction among others have been reported as causes of paediatric renal diseases in sub-Saharan Africa (Anigilaje & Adesina, 2019 ; Antwi et al., 2015 ; Halle et al., 2017 ; Ladapo et al., 2014 ; Yadav et al., 2016 ). Symptoms specific to renal disease like generalized or facial swelling, haematuria, burning micturition, and oliguria help in early diagnosis and subsequent early intervention to prevent complications (Barakat, 2012 ; Garba et al., 2017 ; Yadav et al., 2016 ). However, paediatrics with renal diseases may exhibit nonspecific signs and symptoms unrelated to the urinary system causing kidney disease to go undetected (Mola & Damte, 2016 ). Paediatric renal diseases are also associated with significant morbidity and mortality, especially among hospitalized patients (Ladapo et al., 2014 ). Death prevalence of 17.7%, 14.4%, 14.1%, 5.1%, and 5% have been reported among paediatrics with renal diseases and is mostly due to AKI, CKD, and acute glomerulonephritis (Anigilaje & Adesina, 2019 ; Ibeneme et al, 2015 ; Ladapo et al., 2014 ; Onifade, 2003 ; Yadav et al., 2016 ). Understanding the epidemiology of paediatric renal diseases is therefore crucial for effective health planning, resource allocation, and provision of quality renal services (Anigilaje & Adesina, 2019 ; Okyere et al., 2020 ). To help address the issue of increased morbidity and mortality among paediatrics renal diseases coupled with the insufficient data on paediatric renal diseases in Ghana, this study assessed the pattern, spectrum, outcome and predictors of dialysis and death among children with paediatric renal diseases at Korle Bu Teaching Hospital (KBTH), Ghana. The findings in this study will also aid efforts to detect renal diseases in their early stages among children for effective diagnosis and management. Methodology Study site, design, population and sample size The study was conducted at KBTH. Medical records of children aged 0–17 with renal diseases who received treatment at KBTH from 2009 to 2022 were reviewed retrospectively. This research used all data available at the time of data collection. Eligibility criteria Participants with a complete set of information diagnosed within the study period were eligible for the study. Children above 17 years and those who were admitted to the facility before 2009 were excluded. Also, children with incomplete data sets were excluded. Sampling and Data Collection Procedure Data from the medical records of participants were sampled for the study. Collected data included demographic characteristics (age, sex), clinical data (type, cause, duration, and symptoms of renal disease), laboratory data (haematological [full blood count], biochemical [kidney function test]), information on dialysis and outcome of treatment (alive, dead). The data was collected from February 2022 to June 2022. Ethical Consideration The study was approved by the Department of Medical Laboratory Science, University of Cape Coast. Ethical clearance was sought from the institutional review board of the Korle Bu Teaching Hospital. The Korle Bu Teaching Hospital Scientific and Technical Committee (KBTH-STC) approved our study protocol. The protocol identification number was KBTH-STC/IRB/000200/2021. All methods were carried out in accordance with relevant guidelines and regulations. Data Analysis Initial entry and organization of data were done using Microsoft Excel (version 2013). The data were cleaned and imported into STATA (StataCorp LLC, College Station, TX 77845, USA) statistical software version 15.1 for analysis. Descriptive statistics (frequency tables) were used. Independent t-test analyses were used to compare biochemical and haematological parameters among participants and to establish predictors of renal disease outcomes among the children, bivariate logistic regression analyses were done. The outcomes were presented in crude odds ratio and adjusted odds ratios respectively. All analyses were done at a 95% confidence interval and p-values less than or equal to 0.05 were considered statistically significant. Results The study involved 353 children (the majority being males [62.18%]) with an average age of 5.91 ± 3.99 and the majority of the participants were aged zero to five years (46.80%) (Table 1). With a median admission duration of 2 months, the majority of the participants were admitted for one month or less (48.01%) with the least number of participants admitted for 9 months and above (25.57%) (Table 1). Table 1 also shows that 2021 had the most number of cases (90) and the least number of cases were reported both in 2009 (1) and 2010 (1). The main types of renal diseases among participants were nephrotic syndrome (39.94%), acute kidney injury (24.65%), and acute glomerulonephritis (13.31%). Other types of renal diseases identified included polycystic kidney disease (0.85%), lupus nephritis (0.57%), and others (ureterostomies, bladder calculus, and dilated ectopic renal pelvis) (1.70%). (Table 2). A mortality of 16.43% was observed among participants resulting mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%) while 7.37% were on dialysis (Table 2). Of those who underwent dialysis, the majority (5.39%) had one to four sessions (Table 2). Table 3 shows the causes of renal disease among participants. The major causes were idiopathic (unknown) causes (26.35%), intravascular heamolysis (20.11%), and infection (18.70%) and the other causes included (DIC, SLE, Kawasaki disease, purpura fulminans) (1.42%) and (ABO incompatibility, ureterostomy, quinine reaction, post nephrotomy, schistosomal glomerulopathy, abnormal immune response) (2.55%). Intravascular haemolysis resulting in renal disease was found to be secondary to conditions such as malaria (n=43), dehydration (n=11), and sepsis (n=7) among others. Similarly, of the 66 infection cases resulting in renal disease, the majority (n=41) were due to Streptococcal infection . (Table 3). Table 4 describes the clinical presentation of the participants. The most frequently reported symptoms were swelling (76.88%), facial puffiness (39.02%), and fever (34.97%) whereas the least frequent symptoms included anorexia (3.18%), anuria (2.89%) and dyspnoea (1.73%). Table 5 shows predictors of dialysis among participants. Female gender (aOR 3.31 ±1.62; 95% CI 1.27 – 8.63, p= 0.01), having high serum urea (>7.8mmol/L) (aOR 6.21 ± 5.03; 95% CI 1.27 – 30.36, p= 0.02), and having acute on chronic kidney disease (aOR 10.19 ±11.87; 95% CI 1.04 – 100.05, p= 0.046) were significant predictors of dialysis. There were over six times increased odds of having dialysis if a child had a high urea concentration compared to having a normal value (aOR 6.21 ± 5.03; 95% CI 1.27 – 30.36, p= 0.02) (Table 5). Being on admission for a month or less (aOR 11.17 ±13.22; 95% CI 1.10 – 113.63, p= 0.04) and more than 5 years (aOR 29.33 ±48.11; 95% CI 1.18 – 730.15, p= 0.04), having high WBC count (aOR 3.47 ± 1.66, 95% CI 1.36 – 8.87, p = 0.009), having acute on chronic kidney disease (aOR 47.30 ± 62.35, 95% CI 3.57 – 626.54, p= 0.003) and having renal impairment (aOR 14.95 ± 19.92, 95% CI 1.10 – 203.63, p=0.004) were significant predictors of death among participant (Table 6). There were over three times increased odds of death among participants with high WBC count compared to those with normal ones (aOR 3.47 ± 1.66, 95% CI 1.36 – 8.87, p = 0.009). Discussion This study assessed the pattern, spectrum, outcome, and predictors of dialysis and death among children with renal disease at the Child Health Department of the KBTH, Accra, Ghana. The majority of our study participants were found to be males (62.2%). This gender pattern is consistent with previous studies conducted by Wordui ( 2021 ) in Ghana (male: female ratio of 1.7:1), Obiagwu et al. ( 2019 ) in Nigeria (male-63.5%) and Anigilaje & Adesina ( 2019 ) in Nigeria (male-58.3%). These findings, therefore, stand to suggest that males are a higher risk group for paediatric renal diseases than females. The average age of the participants was 5.9 ± 3.99 years. This finding is also in line with Anigilaje & Adesina’s research in 2019 at Nigeria (mean age of 5.9 ± 4.7 years) but slightly differed from that reported by Derakhshan et al (2014) in Iran (mean of 6.5 ± 4.7 years) and Wordui ( 2021 ) in Ghana (Mean age of 6.6 ± 3.8 years). This slight difference could be due to differences in the study population since Derakhshan et al (2014) and Wordui, ( 2021 ) excluded the neonatal age group (children less than one month and less than two weeks old respectively). Obiagwu et al, ( 2019 ), however, reported a mean age of 8.7 ± 3.9 years which was significantly higher than what our study reported. The smaller sample size (244), study design, population, and period (30 months prospective study excluding children aged less than two years) used in Obiagwu’s study could account for the significant difference. The majority of the participants in our study were aged from 0 to 5 years (46.8%). This is also similar to what was reported by Anigilaje & Adesina ( 2019 ) and Mola & Damte ( 2016 ) as both reported their predominant age group to be less than 5 years of age (46% reported by each study). Our finding however differed from studies conducted by Yadav et al ( 2016 ) and Obiagwu et al ( 2019 ) who reported children aged 6 to 10 years (44.1%) and 10 to 15 years (45%) as the predominant population in their study respectively. These variations could be due to differences in sample size, study design, and duration. It could also be due to variations in the rates of renal diseases among each year group. In agreement with Wordui ( 2021 ) (NS-65.5%), Obiagwu et al ( 2019 ) (NS-33.6%) and Adedoyin et al ( 2012 ) (NS-42.1%), our study also reported nephrotic syndrome (NS) (39.9%) as the most common renal disease. This finding differed from studies conducted in Nigeria and Nepal by Anigilaje & Adesina ( 2019 ), Ocheke et al ( 2010 ), and Yadav et al ( 2016 ) who reported [urinary tract infection (30.7%) and acute kidney injury(30.7%)], acute glomerulonephritis (37.7%) and acute glomerulonephritis (37.7%) as the most common renal diseases. Although the reasons for the disparity in the spectrum of renal diseases are unclear, they may be linked to variations in environmental risk factors for renal diseases, clinical and laboratory capacities to diagnose renal diseases, referral patterns, research duration, and sample size. Acute kidney injury (24.65%) was the second most frequent renal disease in this study. This directly correlates with the high AKI incidence (31.02%) reported by Antwi et al. ( 2015 ) in Kumasi. This indicates a significant burden of acute kidney injury among hospitalized children in Ghana. From our study, the major causes of pediatric renal diseases were idiopathic (unknown) causes (26.3%), intravascular hemolysis (20.1%), infection (18.7%), and hypertension (17.0%). The increased number of idiopathic (unknown) causes of renal diseases is a novel finding as it has not been reported in comparable studies from sub-Saharan Africa (Anigilaje & Adesina, 2019 ; Antwi et al., 2015 ; Obiagwu et al, 2019 ; Wordui, 2021 ; Yadav et al., 2016 ). Late presentation of disease commonly due to poor disease characterization which may probably reflect late referral and the unavailability of diagnostic services in hospitals making it difficult to evaluate the etiology of the disease could account for the increased number of unknown causes. However, similar causes such as infection by Streptococcus spp., Escherichia coli, Staphylococcus spp. and Klebsiella spp. , sepsis, hypertension, diarrhoea, severe malaria among others have been reported in similar studies by Anigilaje & Adesina ( 2019 ), Halle et al ( 2017 ), Yadav et al ( 2016 ), Ladapo et al ( 2014 ), Antwi et al ( 2015 ) and Adedoyin et al ( 2012 ). This study reported a variety of clinical presentations (symptoms) among children with renal disease. Swelling (41.04%), facial puffiness (39.02%), fever (34.97%), pains (27.75%), and abdominal distension (24.57%) were the most common symptoms among participants. Similar clinical presentations including fever, swelling, vomiting, abdominal distension, pain, facial swelling, and anuria among others have also been reported in similar studies by Anigilaje & Adesina ( 2019 ), Halle et al ( 2017 ) and Yadav et al ( 2016 ). However, the variety of clinical presentations observed in paediatric renal patients could be due to the stage of disease at presentation and underlying etiologies. According to our study, 7.37% of the participants were on dialysis. This finding is lower than the 12.14% reported by Antwi et al ( 2015 ) in Kumasi. Financial difficulty in accessing dialysis services could account for our observation. Furthermore, our study revealed that female gender, high serum urea, and acute or chronic kidney disease are significant predictors of dialysis in children with renal diseases. The study also revealed a death prevalence of 16.43% which is higher than the 14.1%, 14.4%, 5.1%, and 5% death prevalence reported among paediatric renal disease patients (Anigilaje & Adesina, 2019 , Ladapo et al., 2014 , Yadav et al., 2016 and Ibeneme et al, 2015 ). The high mortality rate found in our study can be attributed to a number of factors, including the severity of the renal disease at presentation in the hospital, the inappropriateness of treatment, the impact of the underlying disease, and the financial constraints, especially for those requiring this intervention. Study design, duration and sample size could also account for the high mortality rate in this study. This death prevalence resulted mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%). This is similar to studies by Anigilaje & Adesina ( 2019 ) and Onifade ( 2003 ) who reported AKI, CKD, and acute glomerulonephritis to be majorly associated with death among children with renal diseases. We also found that being admitted for a month or less and more than 5 years, having a high WBC count, having acute or chronic kidney disease, and having renal impairment are all significant predictors of death in children with renal disease, and thus these parameters should be closely monitored during their treatment. In contrast, Halle et al ( 2017 ) reported young age, presence of a coma, use of herbal concoctions, and acute pulmonary edema as factors associated with mortality among children with renal disease. Our study has a few limitations. To begin with, our study was retrospective, so biases such as patient selection and access to information are unavoidable, as some children may have been inadvertently excluded from the register. This can be observed with the few numbers of cases recorded from 2009 to 2014. Additionally, our study could not account for the total number of participants who needed dialysis, those who could not get assess to dialysis, and the number of deaths associated with dialysis. Conclusion This study provides an insight into the burden of paediatric renal diseases, their relative occurrence, clinical profile, causes, outcomes, and predictors of death and dialysis thereby providing data for health policymakers to tackle and resolve this disease. Infectious agents and various conditions resulting in intravascular hemolysis contribute to the incidence of pediatric renal diseases in Ghana and must be adequately examined and treated to prevent them from progressing into various forms of renal diseases. This study also heightens the need for routine screening for renal diseases in children, the development of paediatric renal services with access to subsidized renal healthcare services to improve the health status, well-being, and early detection of paediatric renal diseases. Declarations ACKNOWLEDGEMENT We are grateful to the paediatricians (Dr. Victoria May Adabayeri and Dr. Seyram M. Wordui) and the Biostatistics Unit of the Child Health Department of KBTH for making folders of paediatric renal cases available for data collection. Data availability: All data generated or analyzed during this study are available upon request from the corresponding author. Funding: The work was funded by the authors. Conflict of Interest: Authors declare no conflicting interest. Authors contribution: RKDE, GNO, EW, BEAG, and PO conceived and designed this study. GNO, EW, BEAG and FB were responsible for data collection and analysis. GNO, SKD, EW, and BEAG were responsible for data visualization. RKDE and GNO drafted the manuscript. All authors revised the manuscript critically for important intellectual content. All authors read and agreed with the final manuscript. References Adedoyin, O. T., Adesiyun, O. A., Mark, F., & Adeniyi, A. (2012). Childhood renal disorders in Ilorin, north central Nigeria. The Nigerian Postgraduate Medical Journal , 19 (2), 88—91. http://europepmc.org/abstract/MED/22728973 Anigilaje, E. A., & Adesina, T. C. (2019). The Pattern and Outcomes of Childhood Renal Diseases at University of Abuja Teaching Hospital , Abuja , Nigeria : A 4 year Retrospective Review . 53–60. https://doi.org/10.4103/npmj.npmj Antwi, S., Sarfo, A., Amoah, A., Appia, A. S., & Obeng, E. (2015). Topic : Acute Kidney Injury in Children : 3-Year Data Review from Ghana ClinMed . 2–5. Barakat, A. J. (2012). Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist. 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Epidemiology and outcomes of children with renal failure in the pediatric ward of a tertiary hospital in Cameroon . 1–7. https://doi.org/10.1186/s12887-017-0955-0 Ibeneme CA, Okoronkwo N, Ezuruike E, Nwala G, O. T. (2015). Pattern of Childhood Renal disorders in Umuahia , South East Results. Int J Med Health Dev , 20 (1), 21–29. Ladapo, T. A., Esezobor, C. I., & Lesi, F. E. (2014). Pediatric kidney diseases in an African country: prevalence, spectrum and outcome. Saudi Journal of Kidney Diseases and Transplantation : An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia , 25 (5), 1110–1116. https://doi.org/10.4103/1319-2442.139976 Mola Kebede & Damte, S. (2016). PATTERN AND OUTCOME OF RENAL DISEASES IN HOSPITALIZED CHILDREN IN TIKUR ANBESSA SPECIALIZED TEACHING HOSPITAL , . 54 (3), 117–123. Obiagwu et al, 2019. (2019). Pattern of Renal Diseases in Children Attending Paediatric Nephrology Clinic of Aminu Kano Teaching Hospital, Kano . Ocheke, I. 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(2016). of Kidney Diseases and Transplantation Renal Data from Asia-Africa Pattern of Renal Diseases in Children : A Developing Country Experience . 27 (2), 371–376. Tables Table 1: Demographic characteristics, duration of admission and trend of disease over years among study participants. Variable Number (n) Percentage (%) Age Category (n=344); Mean = 5.91 ± 3.99 0 to 5 years 161 46.80 5.1 to 10 years 128 37.21 10.1 to 15 years 55 15.99 Sex (n=349) Male 217 62.18 Female 132 37.82 Duration of admission (n=352); Median = 2 months 1 month or less 169 48.01 Between 1 and 9 months 93 26.42 9 months and above 90 25.57 Year (n=350) 2009 1 0.29 2010 1 0.29 2011 5 1.43 2012 3 0.86 2013 8 2.29 2014 9 2.57 2015 19 5.43 2016 10 2.86 2017 45 12.86 2018 24 6.86 2019 68 19.43 2020 49 14.00 2021 90 25.71 2022 18 5.14 Tables 2 is available in the Supplementary Files section. Table 3: Causes of renal disease among study participants. Variable Number (n) Percentage (%) Cause of Renal Disease (n=353) Idiopathic 93 26.35 Intravascular haemolysis secondary to 71 20.11 Malaria (severe, complicated, cerebral) Dehydration e.g. due to diarrhea 43 11 12.18 3.12 Sepsis 7 1.98 Gastroenteritis 3 0.85 Sickle cell disease 3 0.85 None (General haemolysis) 3 0.85 G6PD 1 0.28 Infection 66 18.70 Streptococcal infection 41 11.61 Bacterial (E. coli, Klebsiella spp., Staphylococcus spp., Pseudomonas spp.) 13 3.68 Urinary Tract Infections 6 1.70 Enterobacterial infection 2 0.56 Human Immunodeficiency Virus (HIV) 2 0.56 Endocarditis and osteomyelitis 2 0.56 Hypertension 60 17.00 Congenital 13 3.68 Renal impairment/disease, nephritis 8 2.27 Encephalopathy (hypertensive, hypoxic, chronic, etc.) 6 1.70 Birth asphyxia 5 1.42 Herbal medicine intoxication 4 1.13 Anaemia 4 1.13 Obstruction (hydronephrosis, bladder outlet, pelvi-ureteric junction) 3 0.85 Minimal Change 3 0.85 Urethral valve/stricture 3 0.85 DIC, SLE, Kawasaki disease, purpura fulminans 5 1.42 Others (ABO incompatibility, ureterostomy, quinine reaction, post nephrotomy, schistosomal glomerulopathy, intrinsic, relapse, abnormal immune response) 9 2.55 Table 4. Clinical characteristics of study participants. Variable Number (n) Percentage (%) **Common Presenting Symptoms (n=346) Swelling (Body, pedal, scrotal, leg, generalized) 266 76.88 Facial Puffiness 135 39.02 Fever 121 34.97 Pains (Abdomen, joint, chest, knee, generalized) 96 27.75 Abdominal distension 85 24.57 Vomiting 83 23.99 Cough 77 22.25 Difficulty breathing 55 15.90 Haematuria 48 13.87 Skin rashes 46 13.29 Pale 36 10.40 Oliguria 31 8.96 Headache 27 7.80 Diarrhoea 24 6.94 Dysuria 14 4.05 Sore throat 13 3.76 Anorexia 11 3.18 Anuria 10 2.89 Dyspnoea 6 1.73 **Multiple responses applicable Table 5: Predictors of dialysis among participants. Variable cOR ± SE p-value 95% CI aOR ± SE p-value 95% CI Sex (Male) Ref Ref Ref Ref Ref Ref Female 2.40 ± 0.99 0.03 1.07 – 5.40 3.31 ± 1.62 0.01 1.27 – 8.63 Age Category (10 years 1.91 ± 1.13 0.274 0.60 – 6.11 - - - Haemoglobin (Normal: Hb>11.0g/dL) Ref Ref Ref Ref Ref Anaemia 7.74 ± 5.77 0.006 1.79 – 33.35 3.22 ± 2.63 0.153 0.65 – 15.99 Urea (Normal Urea: ≤7.8mmol/L) Ref Ref Ref Ref Ref High Urea 17.95 ± 13.37 15 x10 9 /L 0.66 ± 0.34 0.415 - - - - Type of Kidney Disease (nephrotic syndrome) Ref Ref Ref Ref Acute kidney injury 34.95 ± 36.41 0.001 4.54 – 269.22 9.99 ± 11.79 0.051 0.99 – 100.90 Acute on CKD 36.81 ± 40.11 0.001 4.35 – 311.44 10.19 ± 11.87 0.046 1.04 – 100.05 Renal impairment 11.83 ± 14.73 0.05 1.03 – 135.64 11.90 ± 16.11 0.067 0.06 – 2.87 WBC = White Blood Cells; Hb = Haemoglobin; CKD = Chronic Kidney Disease; Creatinine had no odds due to co-linearity (all children who went for dialysis had high creatinine results) Table 6: Predictors of death among study participants. Variable cOR ± SE p-value 95% CI aOR ± SE p-value 95% CI Duration admitted (being admitted 6 -12 months) Ref Ref Ref Ref 1 months and below 16.42 ± 16.96 0.007 2.16 – 124.37 11.17 ± 13.22 0.04 1.10 – 113.63 1 to 3 months 4.92 ± 5.29 0.138 0.60 – 40.46 3.22 ± 4.12 0.360 0.26 – 39.46 3 to 6 months 1.49 ± 1.85 0.749 0.13 – 17.09 1.26 ± 1.82 0.871 0.08 – 21.22 1 – 5 years 3.75 ± 4.13 0.230 0.43 – 32.48 5.03 ± 6.42 0.205 0.41 – 61.35 Above 5 years 7.00 ± 8.93 0.127 0.57 – 85.38 29.33 ± 48.11 0.04 1.18 – 730.15 Haemoglobin (Normal Hb: Hb>11.0g/dL) Ref Ref Ref Ref Ref Anaemia (Low Hb) 3.16 ± 1.22 0.003 1.47 – 6.75 1.79 ± 1.01 0.300 0.59 – 5.42 WBC Count (≤15 x10 9 /L) Ref Ref Ref Ref Ref >15 x10 9 /L 3.22 ± 1.01 <0.0001 1.74 – 5.97 3.47 ± 1.66 0.009 1.36 – 8.87 Urea (Normal Urea: ≤7.8mmol/L) Ref Ref Ref Ref Ref High Urea 8.33 ± 3.08 <0.0001 4.03 – 17.20 2.61 ± 1.94 0.197 0.61 – 11.21 Creatinine (Normal Creatinine: ≤100umol/L Ref Ref Ref High Creatinine 7.58 ± 2.54 <0.0001 3.94 – 14.61 0.92 ± 0.70 0.913 0.21 – 4.05 Cause of Kidney disease (Hypertension) Ref Ref Ref Ref Ref Idiopathic 3.05 ± 2.04 0.095 0.82 – 11.28 3.32 ± 3.07 0.193 0.54 – 20.29 Intra. haemolysis 6.92 ± 4.56 0.003 1.90 – 25.16 2.38 ± 2.28 0.366 0.36 – 15.57 Infection 3.34 ± 2.25 0.074 0.89 – 12.53 3.87 ± 3.89 0.179 0.54 – 27.79 Other causes 8.34 ± 5.52 0.001 2.28 – 30.52 6.32 ± 6.49 0.072 0.85 – 47.24 Type of Kidney Disease (Acute Glomerulonephritis) Ref Ref Ref Ref Nephrotic Syndrome 2.37 ± 2.56 0.426 0.28 – 19.76 3.10 ± 4.02 0.383 0.24 – 39.32 Acute Kidney Injury 15.08 ± 15.73 0.009 1.95 – 116.51 5.38 ± 6.46 0.161 0.51 – 56.58 Acute on CKD 74.31 ± 79.56 <0.0001 9.11 – 605.85 47.30 ± 62.35 0.003 3.57 – 626.54 Renal Impairment 21.65 ± 23.77 0.005 2.52 – 186.21 14.95 ± 19.92 0.04 1.10 – 203.63 Others 2.19 ± 3.15 0.586 0.13 – 36.73 1.92 ± 3.09 0.685 0.08 – 44.82 WBC = White Blood Cells; Hb = Haemoglobin; CKD = Chronic Kidney Disease Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2582884","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":185838729,"identity":"866f6c09-fd43-4767-83ee-1d45f43a10fe","order_by":0,"name":"George Nkrumah Osei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYLCCBAMJO34kvgEQHyCgpcImWbKBmRQtDGfSGDccIFaLvHv7wwcP2w4zG58/f0yCsc1OnoG9eZsEw687OLUYnjljbJDYdpjP7EYyG1BLsmEDz7EyCca+Z7i1zMhhkwBqYTa7wQzSciCBQSLHTIKx5zAeLenPfwC1MG7uPwzVIv8GvxZ5iQQzhgSQ9xmSYbbwmEkw/MCtxYDnjLEEKJAlbiQbWyScSzZs40krtkhswGNLe/vDjz9AUdl/8OGND2V28vzshzfe+PAHjy0HkHkJQMwGYiS24dTBIN+AXfwPbi2jYBSMglEw4gAAi25UWjaGMskAAAAASUVORK5CYII=","orcid":"","institution":"University of Cape Coast","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"George","middleName":"Nkrumah","lastName":"Osei","suffix":""},{"id":185838730,"identity":"76355f26-be1e-4b40-8053-5a2bd752c475","order_by":1,"name":"Emmanuel Worae","email":"","orcid":"","institution":"University of Cape Coast","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"","lastName":"Worae","suffix":""},{"id":185838731,"identity":"b9491911-ac16-4b02-aacb-0f5e936b9713","order_by":2,"name":"Betty Effie Adoko Ghartey","email":"","orcid":"","institution":"University of Cape Coast","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Betty","middleName":"Effie Adoko","lastName":"Ghartey","suffix":""},{"id":185838738,"identity":"f4213799-3c82-40e8-a69f-4ca669fbe0f1","order_by":3,"name":"Perditer Okyere","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Perditer","middleName":"","lastName":"Okyere","suffix":""},{"id":185838743,"identity":"09d6a6c9-c269-4b61-876c-1b995b9b1bdb","order_by":4,"name":"Felix Botchway","email":"","orcid":"","institution":"Accra Technical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Felix","middleName":"","lastName":"Botchway","suffix":""},{"id":185838746,"identity":"355202a7-b21b-4810-81c6-32a48bda1630","order_by":5,"name":"Sampson K. Djonor","email":"","orcid":"","institution":"Korle Bu Teaching Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sampson","middleName":"K.","lastName":"Djonor","suffix":""},{"id":185838747,"identity":"bcb0b4a2-6e55-4ef9-89c2-fb7244efb40e","order_by":6,"name":"Richard K D Ephraim","email":"","orcid":"","institution":"University of Cape Coast","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Richard","middleName":"K D","lastName":"Ephraim","suffix":""}],"badges":[],"createdAt":"2023-02-13 15:44:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2582884/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2582884/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49354336,"identity":"06591349-bd83-417c-ae71-509a34460526","added_by":"auto","created_at":"2024-01-09 07:37:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":558043,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2582884/v1/c971a689-ef36-45d5-b047-2af5b3c5a0c5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Predictors of dialysis and death among paediatric renal disease patients: A 14-year retrospective study at Korle Bu Teaching Hospital, Ghana.","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePaediatric nephrology is not the first concern in developing countries contrary to developed countries in relation to its preventive and curative measures (Cochat et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). This is partly due to inadequate data on paediatric renal diseases and a focus on communicable diseases in developing countries (Ladapo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Data from hospital-based studies have reported the burden of paediatric renal diseases in developing countries, with the prevalence of 2.2%, 3.3%, 6.9%, and 8.9% observed in Nigeria, Ethiopia, Nepal, and Nigeria respectively (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Ibeneme et al, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Mola Kebede \u0026amp; Damte, 2016; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). This reveals that renal diseases are common among children in Nigeria, Ethiopia, and possibly other developing countries.\u003c/p\u003e \u003cp\u003eAcute kidney injury (AKI), nephrotic syndrome (NS), acute glomerulonephritis (AGN), and urinary tract infection (UTI) are the most reported paediatric renal diseases in sub-Saharan Africa (Adedoyin et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Antwi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Derakhshan et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Mola Kebede \u0026amp; Damte, 2016; Obiagwu et al, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Ocheke et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Wordui, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). However, the prevalence of CKD remains low in sub-Saharan Africa (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Derakhshan et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Mola Kebede \u0026amp; Damte, 2016; Obiagwu et al, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Onifade, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Wordui, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Aetiology of paediatric renal diseases varies widely according to the clinical setting, geographical region, and age (Antwi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Infection, sepsis, hypertension, diarrhoea, severe malaria and herbal concoction among others have been reported as causes of paediatric renal diseases in sub-Saharan Africa (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Antwi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Halle et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Ladapo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSymptoms specific to renal disease like generalized or facial swelling, haematuria, burning micturition, and oliguria help in early diagnosis and subsequent early intervention to prevent complications (Barakat, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Garba et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). However, paediatrics with renal diseases may exhibit nonspecific signs and symptoms unrelated to the urinary system causing kidney disease to go undetected (Mola \u0026amp; Damte, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePaediatric renal diseases are also associated with significant morbidity and mortality, especially among hospitalized patients (Ladapo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Death prevalence of 17.7%, 14.4%, 14.1%, 5.1%, and 5% have been reported among paediatrics with renal diseases and is mostly due to AKI, CKD, and acute glomerulonephritis (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Ibeneme et al, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Ladapo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Onifade, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Understanding the epidemiology of paediatric renal diseases is therefore crucial for effective health planning, resource allocation, and provision of quality renal services (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Okyere et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). To help address the issue of increased morbidity and mortality among paediatrics renal diseases coupled with the insufficient data on paediatric renal diseases in Ghana, this study assessed the pattern, spectrum, outcome and predictors of dialysis and death among children with paediatric renal diseases at Korle Bu Teaching Hospital (KBTH), Ghana. The findings in this study will also aid efforts to detect renal diseases in their early stages among children for effective diagnosis and management.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy site, design, population and sample size\u003c/h2\u003e \u003cp\u003eThe study was conducted at KBTH. Medical records of children aged 0\u0026ndash;17 with renal diseases who received treatment at KBTH from 2009 to 2022 were reviewed retrospectively. This research used all data available at the time of data collection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eParticipants with a complete set of information diagnosed within the study period were eligible for the study. Children above 17 years and those who were admitted to the facility before 2009 were excluded. Also, children with incomplete data sets were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSampling and Data Collection Procedure\u003c/h2\u003e \u003cp\u003eData from the medical records of participants were sampled for the study. Collected data included demographic characteristics (age, sex), clinical data (type, cause, duration, and symptoms of renal disease), laboratory data (haematological [full blood count], biochemical [kidney function test]), information on dialysis and outcome of treatment (alive, dead). The data was collected from February 2022 to June 2022.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eEthical Consideration\u003c/h2\u003e \u003cp\u003e The study was approved by the Department of Medical Laboratory Science, University of Cape Coast. Ethical clearance was sought from the institutional review board of the Korle Bu Teaching Hospital. The Korle Bu Teaching Hospital Scientific and Technical Committee (KBTH-STC) approved our study protocol. The protocol identification number was KBTH-STC/IRB/000200/2021. All methods were carried out in accordance with relevant guidelines and regulations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eInitial entry and organization of data were done using Microsoft Excel (version 2013). The data\u003c/p\u003e \u003cp\u003ewere cleaned and imported into STATA (StataCorp LLC, College Station, TX 77845, USA) statistical software version 15.1 for analysis. Descriptive statistics (frequency tables) were used. Independent t-test analyses were used to compare biochemical and haematological parameters among participants and to establish predictors of renal disease outcomes among the children, bivariate logistic regression analyses were done. The outcomes were presented in crude odds ratio and adjusted odds ratios respectively. All analyses were done at a 95% confidence interval and p-values less than or equal to 0.05 were considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe study involved 353 children (the majority being males [62.18%]) with an average age of 5.91 \u0026plusmn; 3.99 and the majority of the participants were aged zero to five years (46.80%) (Table 1). With a median admission duration of 2 months, the majority of the participants were admitted for one month or less (48.01%) with the least number of participants admitted for 9 months and above (25.57%) (Table 1). Table 1 also shows that 2021 had the most number of cases (90) and the least number of cases were reported both in 2009 (1) and 2010 (1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe main types of renal diseases among participants were nephrotic syndrome (39.94%), acute kidney injury (24.65%), and acute glomerulonephritis (13.31%). Other types of renal diseases identified included\u0026nbsp;polycystic kidney disease\u0026nbsp;(0.85%), lupus nephritis\u0026nbsp;(0.57%),\u0026nbsp;and\u0026nbsp;others (ureterostomies, bladder calculus, and dilated ectopic renal pelvis)\u0026nbsp;(1.70%). (Table 2). A mortality of 16.43% was observed among participants resulting mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%) while 7.37% were on dialysis (Table 2). Of those who underwent dialysis, the majority (5.39%) had one to four sessions (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 3 shows the causes of renal disease among participants. The major causes were idiopathic (unknown) causes (26.35%), intravascular heamolysis (20.11%), and infection (18.70%) and the other causes included (DIC, SLE, Kawasaki disease, purpura fulminans) (1.42%) and (ABO incompatibility, ureterostomy,\u0026nbsp;quinine reaction, post nephrotomy,\u0026nbsp;schistosomal glomerulopathy,\u0026nbsp;abnormal immune response) (2.55%). Intravascular haemolysis resulting in renal disease was found to be secondary to conditions such as malaria (n=43), dehydration (n=11), and sepsis (n=7) among others. Similarly, of the 66 infection cases resulting in renal disease, the majority (n=41) were due to \u003cem\u003eStreptococcal\u0026nbsp;\u003c/em\u003einfection\u003cem\u003e.\u0026nbsp;\u003c/em\u003e(Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4 describes the clinical presentation of the participants. The most frequently reported symptoms were swelling (76.88%), facial puffiness (39.02%), and fever (34.97%) whereas the least frequent symptoms included anorexia (3.18%), anuria (2.89%) and dyspnoea (1.73%).\u003c/p\u003e\n\u003cp\u003eTable 5 shows predictors of dialysis among participants. Female gender (aOR 3.31 \u0026plusmn;1.62; 95% CI 1.27 \u0026ndash; 8.63, p= 0.01), having high serum urea (\u0026gt;7.8mmol/L) (aOR 6.21 \u0026plusmn; 5.03; 95% CI 1.27 \u0026ndash; 30.36, p= 0.02), and having acute on chronic kidney disease (aOR 10.19 \u0026plusmn;11.87; 95% CI 1.04 \u0026ndash; 100.05, p= 0.046) were significant predictors of dialysis. There were over six times increased odds of having dialysis if a child had a high urea concentration compared to having a normal value (aOR 6.21 \u0026plusmn; 5.03; 95% CI 1.27 \u0026ndash; 30.36, p= 0.02) (Table 5).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBeing on admission for a month or less (aOR 11.17 \u0026plusmn;13.22; 95% CI 1.10 \u0026ndash; 113.63, p= 0.04) and more than 5 years (aOR 29.33 \u0026plusmn;48.11; 95% CI 1.18 \u0026ndash; 730.15, p= 0.04), having high WBC count (aOR 3.47 \u0026plusmn; 1.66, 95% CI 1.36 \u0026ndash; 8.87, p = 0.009), having acute on chronic kidney disease (aOR 47.30 \u0026plusmn; 62.35, 95% CI 3.57 \u0026ndash; 626.54, p= 0.003) and having renal impairment (aOR 14.95 \u0026plusmn; 19.92, 95% CI 1.10 \u0026ndash; 203.63, p=0.004) were significant predictors of death among participant (Table 6). There were over three times increased odds of death among participants with high WBC count compared to those with normal ones (aOR 3.47 \u0026plusmn; 1.66, 95% CI 1.36 \u0026ndash; 8.87, p = 0.009).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the pattern, spectrum, outcome, and predictors of dialysis and death among children with renal disease at the Child Health Department of the KBTH, Accra, Ghana.\u003c/p\u003e \u003cp\u003eThe majority of our study participants were found to be males (62.2%). This gender pattern is consistent with previous studies conducted by Wordui (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) in Ghana (male: female ratio of 1.7:1), Obiagwu et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) in Nigeria (male-63.5%) and Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) in Nigeria (male-58.3%). These findings, therefore, stand to suggest that males are a higher risk group for paediatric renal diseases than females. The average age of the participants was 5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.99 years. This finding is also in line with Anigilaje \u0026amp; Adesina\u0026rsquo;s research in 2019 at Nigeria (mean age of 5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7 years) but slightly differed from that reported by Derakhshan et al (2014) in Iran (mean of 6.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7 years) and Wordui (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) in Ghana (Mean age of 6.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8 years). This slight difference could be due to differences in the study population since Derakhshan et al (2014) and Wordui, (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) excluded the neonatal age group (children less than one month and less than two weeks old respectively). Obiagwu et al, (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), however, reported a mean age of 8.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.9 years which was significantly higher than what our study reported. The smaller sample size (244), study design, population, and period (30 months prospective study excluding children aged less than two years) used in Obiagwu\u0026rsquo;s study could account for the significant difference. The majority of the participants in our study were aged from 0 to 5 years (46.8%). This is also similar to what was reported by Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and Mola \u0026amp; Damte (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) as both reported their predominant age group to be less than 5 years of age (46% reported by each study). Our finding however differed from studies conducted by Yadav et al (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) and Obiagwu et al (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) who reported children aged 6 to 10 years (44.1%) and 10 to 15 years (45%) as the predominant population in their study respectively. These variations could be due to differences in sample size, study design, and duration. It could also be due to variations in the rates of renal diseases among each year group.\u003c/p\u003e \u003cp\u003eIn agreement with Wordui (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) (NS-65.5%), Obiagwu et al (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) (NS-33.6%) and Adedoyin et al (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) (NS-42.1%), our study also reported nephrotic syndrome (NS) (39.9%) as the most common renal disease. This finding differed from studies conducted in Nigeria and Nepal by Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), Ocheke et al (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), and Yadav et al (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) who reported [urinary tract infection (30.7%) and acute kidney injury(30.7%)], acute glomerulonephritis (37.7%) and acute glomerulonephritis (37.7%) as the most common renal diseases. Although the reasons for the disparity in the spectrum of renal diseases are unclear, they may be linked to variations in environmental risk factors for renal diseases, clinical and laboratory capacities to diagnose renal diseases, referral patterns, research duration, and sample size. Acute kidney injury (24.65%) was the second most frequent renal disease in this study. This directly correlates with the high AKI incidence (31.02%) reported by Antwi et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) in Kumasi. This indicates a significant burden of acute kidney injury among hospitalized children in Ghana.\u003c/p\u003e \u003cp\u003eFrom our study, the major causes of pediatric renal diseases were idiopathic (unknown) causes (26.3%), intravascular hemolysis (20.1%), infection (18.7%), and hypertension (17.0%). The increased number of idiopathic (unknown) causes of renal diseases is a novel finding as it has not been reported in comparable studies from sub-Saharan Africa (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Antwi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Obiagwu et al, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Wordui, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Late presentation of disease commonly due to poor disease characterization which may probably reflect late referral and the unavailability of diagnostic services in hospitals making it difficult to evaluate the etiology of the disease could account for the increased number of unknown causes. However, similar causes such as infection by \u003cem\u003eStreptococcus spp., Escherichia coli, Staphylococcus spp. and Klebsiella spp.\u003c/em\u003e, sepsis, hypertension, diarrhoea, severe malaria among others have been reported in similar studies by Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), Halle et al (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), Yadav et al (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), Ladapo et al (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), Antwi et al (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) and Adedoyin et al (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study reported a variety of clinical presentations (symptoms) among children with renal disease. Swelling (41.04%), facial puffiness (39.02%), fever (34.97%), pains (27.75%), and abdominal distension (24.57%) were the most common symptoms among participants. Similar clinical presentations including fever, swelling, vomiting, abdominal distension, pain, facial swelling, and anuria among others have also been reported in similar studies by Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), Halle et al (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and Yadav et al (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). However, the variety of clinical presentations observed in paediatric renal patients could be due to the stage of disease at presentation and underlying etiologies.\u003c/p\u003e \u003cp\u003eAccording to our study, 7.37% of the participants were on dialysis. This finding is lower than the 12.14% reported by Antwi et al (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) in Kumasi. Financial difficulty in accessing dialysis services could account for our observation. Furthermore, our study revealed that female gender, high serum urea, and acute or chronic kidney disease are significant predictors of dialysis in children with renal diseases. The study also revealed a death prevalence of 16.43% which is higher than the 14.1%, 14.4%, 5.1%, and 5% death prevalence reported among paediatric renal disease patients (Anigilaje \u0026amp; Adesina, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e, Ladapo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e, Yadav et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e and Ibeneme et al, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The high mortality rate found in our study can be attributed to a number of factors, including the severity of the renal disease at presentation in the hospital, the inappropriateness of treatment, the impact of the underlying disease, and the financial constraints, especially for those requiring this intervention. Study design, duration and sample size could also account for the high mortality rate in this study. This death prevalence resulted mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%). This is similar to studies by Anigilaje \u0026amp; Adesina (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and Onifade (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) who reported AKI, CKD, and acute glomerulonephritis to be majorly associated with death among children with renal diseases. We also found that being admitted for a month or less and more than 5 years, having a high WBC count, having acute or chronic kidney disease, and having renal impairment are all significant predictors of death in children with renal disease, and thus these parameters should be closely monitored during their treatment. In contrast, Halle et al (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) reported young age, presence of a coma, use of herbal concoctions, and acute pulmonary edema as factors associated with mortality among children with renal disease.\u003c/p\u003e \u003cp\u003eOur study has a few limitations. To begin with, our study was retrospective, so biases such as patient selection and access to information are unavoidable, as some children may have been inadvertently excluded from the register. This can be observed with the few numbers of cases recorded from 2009 to 2014. Additionally, our study could not account for the total number of participants who needed dialysis, those who could not get assess to dialysis, and the number of deaths associated with dialysis.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study provides an insight into the burden of paediatric renal diseases, their relative occurrence, clinical profile, causes, outcomes, and predictors of death and dialysis thereby providing data for health policymakers to tackle and resolve this disease. Infectious agents and various conditions resulting in intravascular hemolysis contribute to the incidence of pediatric renal diseases in Ghana and must be adequately examined and treated to prevent them from progressing into various forms of renal diseases. This study also heightens the need for routine screening for renal diseases in children, the development of paediatric renal services with access to subsidized renal healthcare services to improve the health status, well-being, and early detection of paediatric renal diseases.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to the paediatricians (Dr. Victoria May Adabayeri and Dr. Seyram M. Wordui) and the Biostatistics Unit of the Child Health Department of KBTH for making folders of paediatric renal cases available for data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability:\u0026nbsp;\u003c/strong\u003eAll data generated or analyzed during this study are available upon request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe work was funded by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u0026nbsp;\u003c/strong\u003eAuthors declare no conflicting interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contribution:\u0026nbsp;\u003c/strong\u003eRKDE, GNO, EW, BEAG, and PO conceived and designed this study. \u0026nbsp;GNO, EW, BEAG and FB were responsible for data collection and analysis. GNO, SKD, EW, and BEAG were responsible for data visualization. \u0026nbsp;RKDE and GNO drafted the manuscript. All authors revised the manuscript critically for important intellectual content. All authors read and agreed with the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdedoyin, O. T., Adesiyun, O. A., Mark, F., \u0026amp; Adeniyi, A. (2012). Childhood renal disorders in Ilorin, north central Nigeria. \u003cem\u003eThe Nigerian Postgraduate Medical Journal\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(2), 88\u0026mdash;91. http://europepmc.org/abstract/MED/22728973\u003c/li\u003e\n\u003cli\u003eAnigilaje, E. A., \u0026amp; Adesina, T. C. (2019). \u003cem\u003eThe Pattern and Outcomes of Childhood Renal Diseases at University of Abuja Teaching Hospital , Abuja , Nigeria : A 4 year Retrospective Review\u003c/em\u003e. 53\u0026ndash;60. https://doi.org/10.4103/npmj.npmj\u003c/li\u003e\n\u003cli\u003eAntwi, S., Sarfo, A., Amoah, A., Appia, A. S., \u0026amp; Obeng, E. (2015). \u003cem\u003eTopic : Acute Kidney Injury in Children : 3-Year Data Review from Ghana ClinMed\u003c/em\u003e. 2\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eBarakat, A. J. (2012). Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist. \u003cem\u003eInternational Journal of Pediatrics\u003c/em\u003e, \u003cem\u003e2012\u003c/em\u003e(2), 1\u0026ndash;5. https://doi.org/10.1155/2012/978673\u003c/li\u003e\n\u003cli\u003eCochat, P., Mourani, C., Exantus, J., Bourquia, A., Martinez-Pico, M., Adonis-Koffy, L., \u0026amp; Bacchetta, J. (2009). [Pediatric nephrology in developing countries]. \u003cem\u003eMedecine Tropicale : Revue Du Corps de Sante Colonial\u003c/em\u003e, \u003cem\u003e69\u003c/em\u003e(6), 543\u0026mdash;547. http://europepmc.org/abstract/MED/20099663\u003c/li\u003e\n\u003cli\u003eDerakhshan, A., Hosseini, G., Hashemi, A., \u0026amp; Fallahzadeh, M. H. (2004). \u003cem\u003eof Kidney Diseases and Transplantation Original Article Spectrum of In-patient Renal Diseases in Children \u0026ldquo; A Report from Southern part Islamic Republic of Iran .\u0026rdquo;\u003c/em\u003e \u003cem\u003e15\u003c/em\u003e(1), 12\u0026ndash;17.\u003c/li\u003e\n\u003cli\u003eGarba, B. I., Allerg, D., Muhammad, A. S., Obasi, A. B., \u0026amp; Adeniji, A. O. (2017). \u003cem\u003ePresentation and pattern of childhood renal diseases in Gusau , North-Western Nigeria\u003c/em\u003e. \u003cem\u003e11\u003c/em\u003e(2), 11\u0026ndash;13. https://doi.org/10.7196/SAJCH.2017.v11i2.1222\u003c/li\u003e\n\u003cli\u003eHalle, M. P., Lapsap, C. T., Barla, E., Fouda, H., Djantio, H., Moudze, B. K., Akazong, C. A., \u0026amp; Priso, E. B. (2017). \u003cem\u003eEpidemiology and outcomes of children with renal failure in the pediatric ward of a tertiary hospital in Cameroon\u003c/em\u003e. 1\u0026ndash;7. https://doi.org/10.1186/s12887-017-0955-0\u003c/li\u003e\n\u003cli\u003eIbeneme CA, Okoronkwo N, Ezuruike E, Nwala G, O. T. (2015). Pattern of Childhood Renal disorders in Umuahia , South East Results. \u003cem\u003eInt J Med Health Dev\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(1), 21\u0026ndash;29.\u003c/li\u003e\n\u003cli\u003eLadapo, T. A., Esezobor, C. I., \u0026amp; Lesi, F. E. (2014). Pediatric kidney diseases in an African country: prevalence, spectrum and outcome. \u003cem\u003eSaudi Journal of Kidney Diseases and Transplantation : An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(5), 1110\u0026ndash;1116. https://doi.org/10.4103/1319-2442.139976\u003c/li\u003e\n\u003cli\u003eMola Kebede \u0026amp; Damte, S. (2016). \u003cem\u003ePATTERN AND OUTCOME OF RENAL DISEASES IN HOSPITALIZED CHILDREN IN TIKUR ANBESSA SPECIALIZED TEACHING HOSPITAL ,\u003c/em\u003e. \u003cem\u003e54\u003c/em\u003e(3), 117\u0026ndash;123.\u003c/li\u003e\n\u003cli\u003eObiagwu et al, 2019. (2019). \u003cem\u003ePattern of Renal Diseases in Children Attending Paediatric Nephrology Clinic of Aminu Kano Teaching Hospital, Kano\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eOcheke, I. E., Okolo, S. N., Bode-Thomas, F., \u0026amp; Agaba, E. I. (2010). Pattern of childhood renal diseases in Jos, Nigeria: A preliminary report. \u003cem\u003eJournal of Medicine in the Tropics\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(2).\u003c/li\u003e\n\u003cli\u003eOkyere, P., Okyere, I., Ephraim, R. K. D., Attakorah, J., Osafo, C., Arhin, B., Bachelle, S., \u0026amp; Abaka-Yawson, A. (2020). Spectrum and Clinical Characteristics of Renal Diseases in Ghanaian Adults: A 13-Year Retrospective Study. \u003cem\u003eInternational Journal of Nephrology\u003c/em\u003e, \u003cem\u003e2020\u003c/em\u003e, 5\u0026ndash;9. https://doi.org/10.1155/2020/8967258\u003c/li\u003e\n\u003cli\u003eOnifade, E. U. (2003). A ten-year review of childhood renal admissions into the Lagos University Teaching Hospital, Nigeria. \u003cem\u003eNigerian Quarterly Journal of Hospital Medicine\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(3\u0026ndash;4), 1\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eWordui, S. (2021). Pos-824 Pattern of Renal Diseases in the Paediatric Renal Clinic, Korle Bu Teaching Hospital. \u003cem\u003eKidney International Reports\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(4), S358. https://doi.org/10.1016/j.ekir.2021.03.858\u003c/li\u003e\n\u003cli\u003eYadav, S. P., Shah, G. S., Mishra, O. P., \u0026amp; Baral, N. (2016). \u003cem\u003eof Kidney Diseases and Transplantation Renal Data from Asia-Africa Pattern of Renal Diseases in Children : A Developing Country Experience\u003c/em\u003e. \u003cem\u003e27\u003c/em\u003e(2), 371\u0026ndash;376.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Demographic characteristics, duration of admission and trend of disease over years among study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"margin-right: calc(54%); width: 46%;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 66.5585%;\" valign=\"top\" width=\"65.91639871382637%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Category (n=344); Mean =\u0026nbsp;\u003c/strong\u003e5.91 \u0026plusmn; 3.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e0 to 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e46.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e5.1 to 10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e37.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e10.1 to 15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e15.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex (n=349)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e62.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e37.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 66.5585%;\" valign=\"top\" width=\"65.91639871382637%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of admission (n=352); Median = 2 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.3451%;\" width=\"34.08360128617363%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e1 month or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.3451%;\" width=\"34.08360128617363%\"\u003e\n \u003cp\u003e48.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003eBetween 1 and 9 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.3451%;\" width=\"34.08360128617363%\"\u003e\n \u003cp\u003e26.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e9 months and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.3451%;\" width=\"34.08360128617363%\"\u003e\n \u003cp\u003e25.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear (n=350)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e2.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e5.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e2.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e12.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e6.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e19.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e14.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e25.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.1875%;\" valign=\"top\" width=\"36.655948553054664%\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29.6079%;\" valign=\"top\" width=\"29.260450160771704%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.2392%;\" valign=\"top\" width=\"32.958199356913184%\"\u003e\n \u003cp\u003e5.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTables 2 is available in the Supplementary Files section.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Causes of renal disease among study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"644\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.8074%;\" valign=\"top\" width=\"57.674418604651166%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"top\" width=\"20.775193798449614%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"top\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 85.8393%;\" valign=\"top\" width=\"78.44961240310077%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCause of Renal Disease (n=353)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"top\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eIdiopathic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e26.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eIntravascular haemolysis secondary to\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e20.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Malaria \u003cem\u003e(severe, complicated, cerebral)\u003c/em\u003e\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eDehydration e.g. due to diarrhea\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e43\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e11\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e12.18\u003c/p\u003e\n \u003cp\u003e3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eSepsis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e7\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eGastroenteritis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eSickle cell disease\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eNone (General haemolysis)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eG6PD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e1\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e18.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eStreptococcal infection\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e41\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e11.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eBacterial (E. coli, Klebsiella spp., Staphylococcus spp., Pseudomonas spp.)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e3.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eUrinary Tract Infections\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e6\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eEnterobacterial infection\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eHuman Immunodeficiency Virus (HIV)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003e\u003cem\u003eEndocarditis and osteomyelitis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e\u003cem\u003e2\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e17.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eCongenital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e3.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eRenal impairment/disease, nephritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e2.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eEncephalopathy (hypertensive, hypoxic, chronic, etc.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eBirth asphyxia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eHerbal medicine intoxication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eAnaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eObstruction (hydronephrosis, bladder outlet, pelvi-ureteric junction)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eMinimal Change\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eUrethral valve/stricture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eDIC, SLE, Kawasaki disease, purpura fulminans\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 70.4946%;\" valign=\"top\" width=\"61.86046511627907%\"\u003e\n \u003cp\u003eOthers (ABO incompatibility, ureterostomy, quinine reaction, post nephrotomy, schistosomal glomerulopathy, intrinsic, relapse, abnormal immune response)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.4966%;\" valign=\"bottom\" width=\"16.589147286821706%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.6984%;\" valign=\"bottom\" width=\"21.550387596899224%\"\u003e\n \u003cp\u003e2.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Clinical characteristics of study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"621\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"76.97262479871175%\"\u003e\n \u003cp\u003e\u003cstrong\u003e**Common Presenting Symptoms (n=346)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.027375201288244%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eSwelling (Body, pedal, scrotal, leg, generalized)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e76.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eFacial Puffiness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e39.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eFever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e34.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003ePains (Abdomen, joint, chest, knee, generalized)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e27.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eAbdominal distension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e24.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eVomiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e23.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eCough\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e22.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eDifficulty breathing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e15.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eHaematuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e13.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eSkin rashes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e13.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003ePale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e10.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eOliguria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e8.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eHeadache\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e7.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eDiarrhoea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e6.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eDysuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e4.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eSore throat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e3.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eAnorexia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e3.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eAnuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e2.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"56.935483870967744%\"\u003e\n \u003cp\u003eDyspnoea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.06451612903226%\"\u003e\n \u003cp\u003e1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e**Multiple responses applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: Predictors of dialysis among participants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"756\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.80952380952381%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR \u0026plusmn; SE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR\u0026nbsp;\u003c/strong\u003e\u0026plusmn; SE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eSex (Male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.40 \u0026plusmn; 0.99\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.07 \u0026ndash; 5.40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.31 \u0026plusmn; 1.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.27 \u0026ndash; 8.63\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eAge Category (\u0026lt;5yrs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003e5-10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e1.98 \u0026plusmn; 0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e0.78 \u0026ndash; 4.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003e\u0026gt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e1.91 \u0026plusmn; 1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e0.60 \u0026ndash; 6.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"38.75661375661376%\"\u003e\n \u003cp\u003eHaemoglobin (Normal: Hb\u0026gt;11.0g/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eAnaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.74 \u0026plusmn; 5.77\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.79 \u0026ndash; 33.35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e3.22 \u0026plusmn; 2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e0.65 \u0026ndash; 15.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"38.75661375661376%\"\u003e\n \u003cp\u003eUrea (Normal Urea: \u0026le;7.8mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eHigh Urea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e17.95 \u0026plusmn; 13.37\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.17 \u0026ndash; 77.31\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.21 \u0026plusmn; 5.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.27 \u0026ndash; 30.36\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"38.75661375661376%\"\u003e\n \u003cp\u003eWBC count (\u0026le;15 x10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003e\u0026gt;15 x10\u003csup\u003e9\u003c/sup\u003e/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e0.66 \u0026plusmn; 0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e0.415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.079365079365079%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" width=\"47.883597883597886%\"\u003e\n \u003cp\u003eType of Kidney Disease (nephrotic syndrome)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eAcute kidney injury\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e34.95 \u0026plusmn; 36.41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.54 \u0026ndash; 269.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e9.99 \u0026plusmn; 11.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e0.99 \u0026ndash; 100.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eAcute on CKD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e36.81 \u0026plusmn; 40.11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.35 \u0026ndash; 311.44\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e\u003cstrong\u003e10.19 \u0026plusmn; 11.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.046\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.04 \u0026ndash; 100.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.80952380952381%\"\u003e\n \u003cp\u003eRenal impairment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.947089947089948%\"\u003e\n \u003cp\u003e11.83 \u0026plusmn; 14.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.126984126984127%\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.079365079365079%\"\u003e\n \u003cp\u003e1.03 \u0026ndash; 135.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.88888888888889%\"\u003e\n \u003cp\u003e11.90 \u0026plusmn; 16.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.994708994708995%\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.153439153439153%\"\u003e\n \u003cp\u003e0.06 \u0026ndash; 2.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWBC = White Blood Cells; Hb = Haemoglobin; CKD = Chronic Kidney Disease; Creatinine had no odds due to co-linearity (all children who went for dialysis had high creatinine results)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6: Predictors of death among study participants.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"749\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.834886817576564%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR \u0026plusmn; SE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR\u0026nbsp;\u003c/strong\u003e\u0026plusmn; SE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" width=\"49.2%\"\u003e\n \u003cp\u003eDuration admitted (being admitted 6 -12 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003e1 months and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e16.42 \u0026plusmn; 16.96\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.16 \u0026ndash; 124.37\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003e11.17 \u0026plusmn; 13.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.10 \u0026ndash; 113.63\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.834886817576564%\"\u003e\n \u003cp\u003e1 to 3 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e4.92 \u0026plusmn; 5.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.60 \u0026ndash; 40.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e3.22 \u0026plusmn; 4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.26 \u0026ndash; 39.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.834886817576564%\"\u003e\n \u003cp\u003e3 to 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e1.49 \u0026plusmn; 1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.13 \u0026ndash; 17.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e1.26 \u0026plusmn; 1.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.08 \u0026ndash; 21.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.834886817576564%\"\u003e\n \u003cp\u003e1 \u0026ndash; 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e3.75 \u0026plusmn; 4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.43 \u0026ndash; 32.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e5.03 \u0026plusmn; 6.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.41 \u0026ndash; 61.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"23.834886817576564%\"\u003e\n \u003cp\u003eAbove 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e7.00 \u0026plusmn; 8.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.57 \u0026ndash; 85.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003e29.33 \u0026plusmn; 48.11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.18 \u0026ndash; 730.15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"39.06666666666667%\"\u003e\n \u003cp\u003eHaemoglobin (Normal Hb: Hb\u0026gt;11.0g/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eAnaemia (Low Hb)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.16 \u0026plusmn; 1.22\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.47 \u0026ndash; 6.75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e1.79 \u0026plusmn; 1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.59 \u0026ndash; 5.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"39.06666666666667%\"\u003e\n \u003cp\u003eWBC Count (\u0026le;15 x10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003e\u0026gt;15 x10\u003csup\u003e9\u003c/sup\u003e/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.22 \u0026plusmn; 1.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.74 \u0026ndash; 5.97\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.47 \u0026plusmn; 1.66\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.36 \u0026ndash; 8.87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"39.06666666666667%\"\u003e\n \u003cp\u003eUrea (Normal Urea: \u0026le;7.8mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eHigh Urea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e8.33 \u0026plusmn; 3.08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.03 \u0026ndash; 17.20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e2.61 \u0026plusmn; 1.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.61 \u0026ndash; 11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" width=\"49.2%\"\u003e\n \u003cp\u003eCreatinine (Normal Creatinine: \u0026le;100umol/L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eHigh Creatinine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.58 \u0026plusmn; 2.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.94 \u0026ndash; 14.61\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e0.92 \u0026plusmn; 0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.21 \u0026ndash; 4.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" width=\"39.06666666666667%\"\u003e\n \u003cp\u003eCause of Kidney disease (Hypertension)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eIdiopathic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e3.05 \u0026plusmn; 2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.82 \u0026ndash; 11.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e3.32 \u0026plusmn; 3.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.54 \u0026ndash; 20.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eIntra. haemolysis\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.92 \u0026plusmn; 4.56\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.90 \u0026ndash; 25.16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e2.38 \u0026plusmn; 2.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.36 \u0026ndash; 15.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e3.34 \u003cstrong\u003e\u0026plusmn; 2.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.89 \u0026ndash; 12.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e3.87 \u0026plusmn; 3.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.54 \u0026ndash; 27.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eOther causes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e8.34 \u0026plusmn; 5.52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.28 \u0026ndash; 30.52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e6.32 \u0026plusmn; 6.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.85 \u0026ndash; 47.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" width=\"49.2%\"\u003e\n \u003cp\u003eType of Kidney Disease (Acute Glomerulonephritis)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.866666666666667%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.666666666666666%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.133333333333333%\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eNephrotic Syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e2.37 \u0026plusmn; 2.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.28 \u0026ndash; 19.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e3.10 \u0026plusmn; 4.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.24 \u0026ndash; 39.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eAcute Kidney Injury\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.08 \u0026plusmn; 15.73\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.95 \u0026ndash; 116.51\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e5.38 \u0026plusmn; 6.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.51 \u0026ndash; 56.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eAcute on CKD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e74.31 \u0026plusmn; 79.56\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e9.11 \u0026ndash; 605.85\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.30 \u0026plusmn; 62.35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.57 \u0026ndash; 626.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eRenal Impairment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e\u003cstrong\u003e21.65 \u0026plusmn; 23.77\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.52 \u0026ndash; 186.21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e\u003cstrong\u003e14.95 \u0026plusmn; 19.92\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.10 \u0026ndash; 203.63\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.834886817576564%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.312916111850866%\"\u003e\n \u003cp\u003e2.19 \u0026plusmn; 3.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.119840213049267%\"\u003e\n \u003cp\u003e0.586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.848202396804261%\"\u003e\n \u003cp\u003e0.13 \u0026ndash; 36.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.647137150466046%\"\u003e\n \u003cp\u003e1.92 \u0026plusmn; 3.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.122503328894807%\"\u003e\n \u003cp\u003e0.685\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.11451398135819%\"\u003e\n \u003cp\u003e0.08 \u0026ndash; 44.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWBC = White Blood Cells; Hb = Haemoglobin; CKD = Chronic Kidney Disease\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Predictors, renal disease, Ghana, children","lastPublishedDoi":"10.21203/rs.3.rs-2582884/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2582884/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e:\u003c/strong\u003e Paediatric nephropathy, a condition associated with significant morbidity and mortality, is increasing in developing countries. Data on paediatric 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 paediatric renal disease patients at Korle Bu Teaching Hospital (KBTH), Accra, Ghana.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e:\u003c/strong\u003e Among children aged 0-17 years on admission at the Child Health Department of KBTH, a retrospective hospital-based study was conducted. Demographic characteristics, clinical data including type, cause, duration, and symptoms of renal diseases, laboratory data (haemtological and biochemical), information on dialysis and treatment outcome were obtained from their records. Data were analyzed accordingly using STATA software version 15.1.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e:\u003c/strong\u003e A total of 353 children with renal diseases were seen during the study period (2009-2022) (mean age of 5.91 ±3.99), with 217(62.18%) being males. The most common renal diseases were nephrotic syndrome 141(39.94%), acute kidney injury (AKI) 87(24.65%) and acute glomerulonephritis 47(13.31%). Others included polycystic kidney disease (0.85%), lupus nephritis (0.57%), and others (ureterostomies, bladder calculus, and dilated ectopic renal pelvis)(1.70%). Idiopathic causes (26.35%) were the major cause of renal diseases followed by intravascular haemolysis (20.11%), infection (18.70%), and hypertension (17.00%). Swelling (76.88%), facial puffiness (39.02%), fever (34.97%), and abdominal distension (24.57%) were the most common symptoms. A death prevalence of 16.43% resulting mostly from AKI (5.95%), acute on chronic kidney disease (4.25%), and CKD (2.55%) was observed at KBTH whilst 7.37% were on dialysis. Predictors of dialysis included female gender, high urea levels and acute on chronic kidney disease whilst being admitted for a month or less and more than 5 years, high white blood cell count (WBC), acute on chronic kidney disease, and renal impairment were significant predictors of death among children with renal diseases.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e: \u003c/strong\u003ePaediatric renal diseases at KBTH were dominated by nephrotic syndrome and AKI. High WBC count, acute on chronic kidney disease, and renal impairment were significantly associated with death among children with renal diseases. Therefore, much attention should be paid to these parameters during their care.\u003c/p\u003e","manuscriptTitle":"Predictors of dialysis and death among paediatric renal disease patients: A 14-year retrospective study at Korle Bu Teaching Hospital, Ghana.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-03-26 18:46:45","doi":"10.21203/rs.3.rs-2582884/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2dc2c10e-61ef-4b12-8c9e-04974126fa48","owner":[],"postedDate":"March 26th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":20140997,"name":"Health sciences/Medical research"},{"id":20140998,"name":"Health sciences/Nephrology"}],"tags":[],"updatedAt":"2024-01-09T07:29:21+00:00","versionOfRecord":[],"versionCreatedAt":"2023-03-26 18:46:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2582884","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2582884","identity":"rs-2582884","version":["v1"]},"buildId":"ApUGefWb6u5IBVtyqm6d5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}
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