Childhood nephrectomy indications: a changing profile

ABSTRACT

To assess the changing profile of children's nephrectomy indications in the south of Tunisia during the last two decades. There were 94 children who underwent nephrectomy between 1982 and 2007. They were classified into two groups. The first group included 55 out of 511 hospitalized children between 1982 and 1994, the second included 39 Out of 382 hospitalized children between 1995 and 2007. K2 [Chi-squared] test was used for this statistical analysis. A P value of<0.05 was considered statistically significant. The average was 7. Pathologies leading to nephrectomies were dominated in both groups by 3 main aetiologies urolithiasis [42.5%],Wilm's tumors [21.3%] and pelvi-ureteric junction [13.8%]. While in the first group, urolithiasis was found to be the major indication of nephrectomy [54.5%, p<0.05], in the second group, kidney tumors had become the major indication [33%, p<0.05] followed by urolithiasis [25.6%]. So, the rate of nephrectomies performed due to urolithiasis had clearly decrease [P=0.005], but there were no statistical differences observed between the rates of nephrectomies performed due to tumors or upper urinary tract malformations in the two groups. The profile of children's nephrectomy indications in Tunisia stretches currently to be similar to the one of the industrialized countries, with regression of evolved kidney lithiasis leaving place to the tumorous pathologies,because of early detection, improvement and appropriate treatment of urinary lithiasis