Prevalence and predictors of stunting in children and adolescents aged 1-18 years with nephrotic syndrome attending Mulago Hospital, Uganda.

Abstract

Background: Nephrotic syndrome is the predominant glomerulopathy in children worldwide, particularly in low-income countries. One of the key complications of nephrotic syndrome is stunting. Stunting is the most prevalent form of undernutrition globally; which leads to early and long-term consequences. In this study, we determined the prevalence and predictors of stunting among children and adolescents with nephrotic syndrome at a tertiary nephrology clinic in Uganda.

Methods: Between February and August 2022, we conducted a cross-sectional study that enrolled children and adolescents aged 1 to 18 years with nephrotic syndrome. Participants had been undergoing steroid treatment for a minimum of three months and were registered at the paediatric renal clinic of Mulago National Referral Hospital in Kampala, Uganda. Medical history, physical examination and anthropometric assessment were conducted on the enrolled children. The World Health Organisation (WHO) growth reference standards were used to evaluate stunting in the enrolled children. Multivariable logistic regression analysis was performed to determine independent predictors of stunting and a p-value < 0.05 was considered statistically significant.

Results: Ninety-four participants were enrolled, with a median age (IQR) at diagnosis of six years (IQR 3-9). Among the participants, 48 (51.1%) were male. The prevalence of stunting was observed in 15 (15.9%) participants (95% confidence interval [CI]: 15.88 - 16.04). Regarding severity, 12 (12.8%) participants were moderately stunted, and 3 (3.2%) were severely stunted. Participants with persistent proteinuria exhibited higher odds of stunting than those without. (OR: 4.11, 95% CI: 1.05 - 15.98, p < 0.041).

Conclusions: There is a high prevalence of stunting among children with nephrotic syndrome, particularly among those with on-going proteinuria. This underscores the importance of regular growth monitoring and screening for early identification and eventual management of stunting among children receiving care for nephrotic syndrome. Providing nutritional counselling and other interventions is thus crucial in addressing stunting among this specific group of children and adolescents.