Objectives: To determine the proportion of children with chronic kidney disease requiring dialysis; and to determine the factors associated with children with CKD requiring or not requiring dialysis. Methods: This was a hospital based cross-sectional study with prospective enrolment of patients (children 1 to 18 years of age with chronic kidney disease (CKD, glomerular filtration rates less than 60 ml/min/1.73 m2)) conducted in the Department of Paediatrics, in a tertiary healthcare facility in central India between June 2020 and December 2021. Results: The majority of participants were males (81.3%), and three-quarters were aged ten or older. CKD stages varied, with 38.7% at stage 3, 40.0% at stage 4, and 21.3% at stage 5 and/or requiring dialysis. Several nutritional and hematologic abnormalities were observed, with 72.0% of children being underweight, 52.0% having anemia, and 42.7% presenting with proteinuria. Additionally, 46.7% exhibited abnormal calcium-phosphorus (Ca x PO4) product. The study reported a high prevalence of hypertension, with 22.7% having clinical hypertension and 90.7% having ambulatory hypertension. Metabolic disturbances were notable, including hyperkalaemia (17.3%) and acidosis (60.0%). Among children not requiring dialysis (76.0%), a lower mean (SD) Ca x PO4 product was observed (37.2, SD 2.3) compared to those requiring dialysis (41.5, SD 4.7; p<0.001). Hyperphosphatemia and hyperparathyroidism were more common in the dialysis group (66.7%) than in those not requiring dialysis (28.1% and 35.1%, respectively; p<0.05). Proteinuria was more prevalent in non-dialysis patients (89.5%) compared to dialysis patients (66.7%; p<0.05). Furthermore, LVH was significantly higher in the dialysis group (55.6%) compared to the non-dialysis group (21.1%; p<0.05). Children requiring dialysis exhibited higher LV mass, LVMI, and fractional shortening, indicating compromised cardiac function. Ejection fraction was also significantly lower in the dialysis group (51.7 vs. 60.9 in non-dialysis; p<0.05). Conclusion: These results underscore the intricate relationship between CKD, cardiovascular complications, and the impact of dialysis, emphasizing the need for tailored interventions to address the multifaceted challenges faced by children with CKD.

Objectives: To determine the proportion of children with chronic kidney disease requiring dialysis; and to determine the factors associated with children with CKD requiring or not requiring dialysis. Methods: This was a hospital based cross-sectional study with prospective enrolment of patients (children 1 to 18 years of age with chronic kidney disease (CKD, glomerular filtration rates less than 60 ml/min/1.73 m2)) conducted in the Department of Paediatrics, in a tertiary healthcare facility in central India between June 2020 and December 2021. Results: The majority of participants were males (81.3%), and three-quarters were aged ten or older. CKD stages varied, with 38.7% at stage 3, 40.0% at stage 4, and 21.3% at stage 5 and/or requiring dialysis. Several nutritional and hematologic abnormalities were observed, with 72.0% of children being underweight, 52.0% having anemia, and 42.7% presenting with proteinuria. Additionally, 46.7% exhibited abnormal calcium-phosphorus (Ca x PO4) product. The study reported a high prevalence of hypertension, with 22.7% having clinical hypertension and 90.7% having ambulatory hypertension. Metabolic disturbances were notable, including hyperkalaemia (17.3%) and acidosis (60.0%). Among children not requiring dialysis (76.0%), a lower mean (SD) Ca x PO4 product was observed (37.2, SD 2.3) compared to those requiring dialysis (41.5, SD 4.7; p<0.001). Hyperphosphatemia and hyperparathyroidism were more common in the dialysis group (66.7%) than in those not requiring dialysis (28.1% and 35.1%, respectively; p<0.05). Proteinuria was more prevalent in non-dialysis patients (89.5%) compared to dialysis patients (66.7%; p<0.05). Furthermore, LVH was significantly higher in the dialysis group (55.6%) compared to the non-dialysis group (21.1%; p<0.05). Children requiring dialysis exhibited higher LV mass, LVMI, and fractional shortening, indicating compromised cardiac function. Ejection fraction was also significantly lower in the dialysis group (51.7 vs. 60.9 in non-dialysis; p<0.05). Conclusion: These results underscore the intricate relationship between CKD, cardiovascular complications, and the impact of dialysis, emphasizing the need for tailored interventions to address the multifaceted challenges faced by children with CKD.