Medical control dropout in pediatric patients with post-infectious glomerulonephritis history

Authors

DOI:

https://doi.org/10.52379/mcs.v8i1.310

Keywords:

sociodemographics factors, glomerulonephritis, chronic kidney disease, pediatrics, nephritic syndrome

Abstract

Introduction: Post-infectious glomerulonephritis (PIGN) in childhood is a risk factor for the development of long-term chronic kidney disease. Adherence to medical control allows secondary nephroprevention to be carried out. Objective: to evaluate the relationship between risk factors related to non-adherence to medical control of patients with IPGN in a pediatric cohort. Methods: descriptive study, with an analytical component of a retrospective cohort of patients hospitalized between January 2000 and December 2018 in a reference hospital. The relationship between: overcrowding, co-sleeping, maternal and paternal education, number of siblings, cohabitants and origin, with lack of adherence to medical control was analyzed. The chi-square test and logistic regression were used at a significance level of 0.05. Results: a total of 148 patients (103 boys y 45 girls) between 2 and 16 years old (mean age: 8.5± 3.4 years) were included. The lack of adherence was found in 73 patients (49.3%) that was associated with rural origin (p= 0.012, RR: 1.50, 95% CI: 1.10-2.06), low maternal education (p= 0.046, 95%CI: 1.54:1.14-2.08), low paternal education (p= 0.02; RR: 1.483, 95%CI: 1.09-2.01), >3 cohabitants (p=0.007, RR: 1.630, 95% CI: 1.21-2.19), co-sleeping (p=0.026; RR: 1.52, 95% CI: 1.02-2.27) and overcrowding (p<0.0001; RR: 1.92, 95% CI: 1.39-2.65). By logistic regression, overcrowding (p=0.005; OR= 4.8) and rural origin (p=0.022; OR: 2.4) remained associated with lack of adherence. Discussion: Overcrowding and rural origin were independently associated with loss to follow-up. Greater intervention by primary health care is recommended.

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References

Hoy WE, White AV, Dowling A, Sharma SK, Bloomfield H, Tipiloura BT, et al. Post-streptococcal glomerulonephritis is a strong risk factor for chronic kidney disease in later life. Kidney Int. 2012; 81(10):1026-1032. https://doi.org/10.1038/ki.2011.478

Troche A, Samudio M. Glomerulonefritis aguda posinfecciosa como riesgo para desarrollar insuficiencia renal crónica en una cohorte pediátrica de un hospital de referencia en Paraguay. Rev. Colomb. Nefrol. 2023; 10(1), e632. https://doi.org/10.22265/acnef.10.1.632

Arroyo Alcazar R, Orte Martínez L, Otero González A. Enfermedad renal crónica avanzada. Nefrología. 2008;28 (3):3-6. URL.

O'Shaughnessy MM. Social Determinants of Glomerular Disease. Clin J Am Soc Nephrol. 2020;15(3):306-307. https://doi.org/10.2215/CJN.15051219

Garcia-Garcia G, Jha V. Chronic kidney disease in disadvantaged populations. Braz J Med Biol Res. 2015; 48(5):377-381. https://doi.org/10.1590/1414-431X20144519

Ortega Cerda José Juan, Sánchez Herrera Diana, Rodríguez Miranda Óscar Adrián, Ortega Legaspi Juan Manuel. Adherencia terapéutica: un problema de atención médica. Acta méd. Grupo Ángeles. 2018; 16(3):226-232. URL.

Modi AC, Pai AL, Hommel KA, Hood KK, Cortina S, Hilliard ME, et al. Pediatric Self-management: A Framework for Research, Practice, and Policy. Pediatrics. 2012; 129(2): e473–85. https://doi.org/10.1542/peds.2011-1635

Vasylyeva T L., Singh R, Sheehan C, Chennasamudram SP, Hernandez AP. Self-Reported Adherence to Medications in a Pediatric Renal Clinic: Psychological Aspects. Rypma B, editor. PLoS ONE. 2013 ; 8(7):e69060. https://doi.org/10.1371/journal.pone.0069060.

Ingerski L, Perrazo L, Goebel J, Pai ALH. Family Strategies for Achieving Medication Adherence in Pediatric Kidney Transplantation: Nurs Res. 2011 ;60(3):190–6. https://doi.org/10.1097/NNR.0b013e318215fdfe

Instituto Mexicano del Seguro Social. Diagnóstico y Tratamiento del Síndrome Nefrítico Agudo Post estreptocócico en Edad Pediátrica: Guía de referencia rápida. Mexico: CENETEC; 2018. URL.

Dirección General de Estadísticas, Encuestas y Censos, Análisis del déficit habitacional en Paraguay 2012. Internet. Paraguay: DGEEC; 2016. URL.

Tuñon I, Martínez CE. Infancias y colecho en la Argentina: factores sociodemográficos,socioeconómicos y de salud familiar. Rev. Latinoam. cienc. soc. nin?ez ju. 2022;20(1):1-21. https://doi.org/10.11600/rlcsnj.20.1.4312

Dirección General de Estadística, Encuestas y Censos, Secretaría Técnica de Planificación Análisis y Proyección de los Hogares: 2002 – 2020, Internet. Paraguay: DGEEC; 2005. URL.

Ministerio de Educación y Cultura. Realidad urbana – rural. URL.

Samudio A, Diego Figueredo, Torres R, Mattio I, Servín J, Alcaraz E. Estrategias para prevenir el abandono de tratamiento en niños con cáncer en un país en vías de desarrollo. Pediatr. (Asunción), 2013(40) 2:119 – 123. URL.

UNICEF. Determinantes sociales y ambientales para el desarrollo de los niños y niñas desde el periodo del embarazo hasta los 5 años: bases para un dialogo deliberativo. Argentina: UNICEF; 2015. 90 p. URL.

Marinovich S, Lavorato C, Rosa-Diez G, Bisigniano L, Fernández V, Hansen-Krogh D. La falta de ingresos económicos se asocia a menor supervivencia en hemodiálisis crónica. Nefrología. 2012;(32)1:1-132. https://doi.org/10.3265/Nefrologia.pre2011.Nov.11110

Mah SM, Rosella LC, Kivimäki M, Carmeli C. Overcrowded housing during adolescence and future risk of premature mortality: a 28-year follow-up of 556,191 adolescents from Switzerland. The Lancet Regional Health – Europe. 2023,31: 100667 https://doi.org/10.1016/j.lanepe.2023.100667

Bailie RS, Stevens MR, McDonald E, Halpin S, Brewster D, Robinson G, et al. Skin infection, housing and social circumstances in children living in remote Indigenous communities: testing conceptual and methodological approaches. BMC Public Health. 2005, 5:128. https://www.doi.org/10.1186/1471-2458-5-128

Gauchan E, Kumar A, Bk G, Thapa P, Pun J. Relation of Sociodemographics and Personal Hygiene on Different Childhood Dermatoses. Kathmandu Univ Med J (KUMJ). 2015; 29-33. https://doi.org/10.3126/kumj.v13i1.13749

Jasso-Gutiérrez, López Ortega M. El impacto de los Determinantes Sociales de la Salud en los niños. Bol Med Hosp Infant Mex. 2014;71(2):117-125. URL.

Giménez-Caballero E, Amarilla MG, González-De Mestral C, Araújo-Quevedo CM. Evaluación de disponibilidad y preparación de servicios de salud en el primer nivel de atención de cinco regiones sanitarias del Paraguay durante el 2022. Mem. Inst. Investig. Cienc. Salud. 2022;20(3):13-26. https://doi.org/10.18004/mem.iics/1812-9528/2022.020.03.13

Published

01/09/2024

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