ADOLESCENTS WITH URINARY SYSTEM DISEASES IN THEIR FINAL STAGE OF PEDIATRIC NEPHROLOGY CARE: A CROSS-SECTIONAL STUDY BASED ON A REGIONAL HOSPITAL’S 10-YEAR DATABASE

Abstract

Transition of adolescents with kidney diseases from pediatric into adult healthcare system is usually accompanied by clinical, social and psychological problems that are often caused by a patient’s unreadiness. The development of programs intent for the transition preparation requires studying of the peculiarities of the healthcare system resources use by adolescents aged 15 to 17 years old. The purpose of this research was to determine the hospitalisation rate in the nephrology care unit, the nosological structure of diagnosed diseases and the demographic features of hospitalised adolescents aged 15 to 17 y/o. Methods used: a single-centre cross-sectional descriptive study based on a 10-year database of the Nephrology Care Unit named after V.P. Sitnikova of the Voronezh Oblast Regional Children’s Clinical Hospital No. 1 (Voronezh, Russia). Results: 14522 admissions, 24.6% (n=3574) of which were adolescents aged 15 to 17 y/o were analysed: 55.4% (n=1981) boys/44.6% (n=1593) girls. The median hospitalisation rate for patients aged 15 to 17 y/o per 100000 of the corresponding population within the 10-year period was 609.7 in boys and 537.4 in girls. The diagnosis from N10 to N16 ICD-10 code blocks was mainly registered in adolescents of this age group (50% in girls (95% CI 47.5%-52.4%) and 38.2% in boys (95% CI 36.0%-40.3%)). Statistically significant differences in the nosological structure of the diseases between girls and boys were found (p<0.001). The analysed 10-year period was characterised by a positive trend in the registration of the main diagnosis in adolescents from the N17 to N19 ICD-10 code blocks (р=0,023). The average age of the last hospital admission among the patients who completed follow-up in the paediatric nephrology service was 15 [13-17] y/o, of which 26.9% of adolescents were hospitalised at the age of 17 y/o. Conclusion: primary data were obtained to develop a system for preparing adolescents for their transition from paediatric into adult healthcare systems.