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Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study
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-ye...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2023
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| _version_ | 1867613288242610176 |
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| access_status_str | Open Access |
| author | Barday, Zibya |
| author2 | Davidson, Bianca |
| author_browse | Barday, Zibya Davidson, Bianca |
| author_facet | Davidson, Bianca Barday, Zibya |
| author_sort | Barday, Zibya |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37419 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:45.686Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37419 Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study Barday, Zibya Davidson, Bianca Wearne, Nicola Jones, Erika McCulloch, Mignon Nephrology 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. 2023-03-13T13:55:40Z 2023-03-13T13:55:40Z 2022 2023-02-20T12:15:20Z Master Thesis Masters MPhil http://hdl.handle.net/11427/37419 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Nephrology Barday, Zibya Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| thesis_degree_str | Master's |
| title | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| title_full | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| title_fullStr | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| title_full_unstemmed | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| title_short | Clinico-pathological characteristics and outcomes of nephrology adolescents and young adults in Cape Town: a single centre study |
| title_sort | clinico pathological characteristics and outcomes of nephrology adolescents and young adults in cape town a single centre study |
| topic | Nephrology |
| url | http://hdl.handle.net/11427/37419 |
| work_keys_str_mv | AT bardayzibya clinicopathologicalcharacteristicsandoutcomesofnephrologyadolescentsandyoungadultsincapetownasinglecentrestudy |