Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study
| dc.contributor.advisor | Davidson, Bianca | |
| dc.contributor.advisor | Wearne, Nicola | |
| dc.contributor.advisor | Jones, Erika | |
| dc.contributor.advisor | McCulloch, Mignon | |
| dc.contributor.author | Barday, Zibya | |
| dc.date.accessioned | 2023-03-13T13:55:40Z | |
| dc.date.available | 2023-03-13T13:55:40Z | |
| dc.date.issued | 2022 | |
| dc.date.updated | 2023-02-20T12:15:20Z | |
| dc.description.abstract | Background Adolescents and young adults [AYA] are important users of the nephrology health care services. Worldwide, there is a paucity of data on AYA kidney disease and outcomes. This study evaluates kidney outcomes, survival and challenges faced by AYA in a South African setting. Methods This 5-year retrospective study included AYA [aged 10-24] with chronic kidney disease, at a tertiary nephrology service in South Africa. Descriptive analysis characterised the aetiology of kidney disease. A comparative analysis of baseline characteristics, outcomes and social challenges were performed between patients attending a dedicated AYA clinic and those attending the standard adult clinics [non-AYA clinics]. Primary composite outcome assessed included doubling of creatinine, reduction of eGFR >40%, end-stage kidney disease and death. Logistic regression evaluated associations between relevant variables, death and lost to follow up [LTFU]. Results The total AYA cohort consisted of 292 patients, 111 (38.0%) attended the AYA clinic and 181 (62.0%) the non-AYA clinics. The main aetiologies of disease were glomerular 212 (72.6%), congenital anomalies of the urinary tract 31 (10.6%), and hereditary conditions 24 (8.2%). There was a significantly lower mortality (p=0.007) and reduction in LTFU (p=0.012) in the cohort attending the AYA clinic. A statistically significant composite outcome (p=0.018), with improved kidney survival was found in the AYA clinic group. High proportions of nonadherence (33.9%) and substance use (25.0%) was demonstrated in both cohorts. Conclusion This study adds to the dearth of literature on AYA kidney disease. A dedicated nephrology AYA clinic is shown to have lower mortality, less LTFU and improved kidney outcomes, which is essential in a resource-limited setting where access to kidney replacement therapy is restricted. | |
| dc.identifier.apacitation | Barday, Z. (2022). <i>Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/37419 | en_ZA |
| dc.identifier.chicagocitation | Barday, Zibya. <i>"Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2022. http://hdl.handle.net/11427/37419 | en_ZA |
| dc.identifier.citation | Barday, Z. 2022. Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/37419 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - Barday, Zibya AB - Background Adolescents and young adults [AYA] are important users of the nephrology health care services. Worldwide, there is a paucity of data on AYA kidney disease and outcomes. This study evaluates kidney outcomes, survival and challenges faced by AYA in a South African setting. Methods This 5-year retrospective study included AYA [aged 10-24] with chronic kidney disease, at a tertiary nephrology service in South Africa. Descriptive analysis characterised the aetiology of kidney disease. A comparative analysis of baseline characteristics, outcomes and social challenges were performed between patients attending a dedicated AYA clinic and those attending the standard adult clinics [non-AYA clinics]. Primary composite outcome assessed included doubling of creatinine, reduction of eGFR >40%, end-stage kidney disease and death. Logistic regression evaluated associations between relevant variables, death and lost to follow up [LTFU]. Results The total AYA cohort consisted of 292 patients, 111 (38.0%) attended the AYA clinic and 181 (62.0%) the non-AYA clinics. The main aetiologies of disease were glomerular 212 (72.6%), congenital anomalies of the urinary tract 31 (10.6%), and hereditary conditions 24 (8.2%). There was a significantly lower mortality (p=0.007) and reduction in LTFU (p=0.012) in the cohort attending the AYA clinic. A statistically significant composite outcome (p=0.018), with improved kidney survival was found in the AYA clinic group. High proportions of nonadherence (33.9%) and substance use (25.0%) was demonstrated in both cohorts. Conclusion This study adds to the dearth of literature on AYA kidney disease. A dedicated nephrology AYA clinic is shown to have lower mortality, less LTFU and improved kidney outcomes, which is essential in a resource-limited setting where access to kidney replacement therapy is restricted. DA - 2022_ DB - OpenUCT DP - University of Cape Town KW - Nephrology LK - https://open.uct.ac.za PY - 2022 T1 - Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study TI - Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study UR - http://hdl.handle.net/11427/37419 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/37419 | |
| dc.identifier.vancouvercitation | Barday Z. Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study. []. ,Faculty of Health Sciences ,Department of Medicine, 2022 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/37419 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Nephrology | |
| dc.title | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MPhil |