Poteinuria in children admitted to the paediatric department of the University teaching hospital

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Kapakala, Thomas Mwewa
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Background: Proteinuria is a non-specific and common laboratory finding in children that occur in a variety of kidney diseases. The causative factors of proteinuria are varied and may include infections such as Hepatitis B (HBV), HIV or malaria. In this study, we attempt to ascertain the prevalence of proteinuria in children admitted to UTH. Aim: To identify clinical conditions or diseases that may be associated with proteinuria in Zambian children admitted to UTH. Methodology: The study was cross-sectional involving a total of 123 children aged 0-14 years. Informed consent was obtained from the children's parent or guardian before participation. The following activities were conducted; filling in of the questionnaire; clinical physical examination; collection of blood and urine samples; blood laboratory testing for ASOT, VDRL, HbsAg, HIV, malaria, ESR and FBC; urinalysis; counseling for HIV test; data analysis using Epi-lnfo version and Microsoft Excel softwares. Results: 98% of the study subjects resided in Lusaka. 88 (71.5%) of the children were under the age of five years. Of the 123 subjects tested for proteinuria, 82 (66.7 %) were males and 41 (33.3 %) were females giving an approximate male to female ratio of 2:1. Proteinuria was high in subjects from a high density residential area (71.5 %) of which significant proteinuria was 26.8 % (33). There were many variables (conditions) that were significantly associated with proteinuria as indicated by p values. This strongly supports the study hypothesis that proteinuria is a common clinical presentation in children admitted to UTH. Almost half of the subjects were HIV positivie. In this study, 44 (35.8%) out of 123 children had significant proteinuria results and this reflected the prevalence of proteinuria in children admitted to UTH. This is quite high if compared to that of isolated assymptomatic proteinuria in children as seen in the western studies (0.6 - 6.3 %). Significant proteinuria was highest in the under-five age group (33 = 26.8%). Conclusion: The conclusion of this study is that proteinuria is a non-specific and common laboratory finding in children and can be a benign condition or a serious disease. Recommendations: The recommendations are that: urinalysis and other base line investigations should be done routinely on all children admitted to UTH. In addition, HIV testing should be done routinely and the stigmata associated with HIV infection should be fought against by educating the population. Finally, further studies on proteinuria, especially in relation to other disease entities should be done and advocated.