Chronically ill children with kidney disease may spend more time in the hospital, incur larger health care costs and have a higher risk of death compared to paediatric patients hospitalised for other chronic conditions, say researchers, including one of Indian-origin.
And one of the biggest drivers of these outcomes, the study published in the American Journal of Kidney Diseases found, is the level of medical complexity the young patients face.
Many children with chronic kidney disease also have multiple other chronic health conditions that adversely impact the outcomes, including cardiovascular disease, hypertension, diabetes and difficulties in growth.
“We wanted to improve our knowledge of this high-risk population in order to better support the needs of chronically ill children with kidney disease.”Zubin Modi, study author, University of Michigan in the US.
"Our findings suggest that these patients have very complex health needs, and we need to determine more effective ways to provide them with the care they need before, during and after hospitalisation." he added.
Chronic kidney disease includes long term abnormalities of kidney structure or function that may progress to end-stage kidney disease requiring dialysis or a transplant.
Children with the condition are also at risk for acute deteriorations in health secondary to an infection, dehydration, and side effects associated with medications.
Researchers analysed national data during 2006, 2009, 2012, and 2016. Of the 6.5 million national paediatric hospital discharges, nearly four involved children with chronic kidney disease.
The findings showed that children with chronic kidney disease spent about 30 per cent longer in the hospital with nearly 60 per cent more in hospital expenses.
Children with chronic kidney disease were also 50 per cent more likely to die during hospitalisation.
The high health care expenses for hospitalised paediatric patients with end-stage kidney disease, including dialysis, transplantation, and associated complications may be comparable to hospitalized heart failure patients, authors say.
Kidney disease may be associated with more medical complexities, the study authors said.
The causes of chronic kidney disease in children include genetic disorders, congenital anomalies that may be part of a multi-organ system syndrome, and systemic inflammatory disorders
"We need further studies to better understand the health care needs and delivery of care to hospitalized children with chronic kidney disease in order to optimise health outcomes," the authors wrote.
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