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Abstract

Pediatric kidney diseases present a significant clinical and societal health burden in terms of frequent morbidity, impaired function and threat of enduring morbidity. This study compared integrated clinical public health approaches and nephrology-oriented nursing care to the outcome of pediatric renal disease. A descriptive observational study involved children aged 0-18 years old with chronic kidney disease (CKD), acute kidney injury (AKI), and nephrotic syndrome. Outcome patterns and predictors of renal improvement were studied using descriptive statistics, comparative statistics, and regression modelling. This cohort involved 120 children (mean age of 9.4 years, 32% AKI, 48% CKD, 20% nephrotic syndrome). Mean estimated glomerular filtration rate (eGFR) rose to 45% at 6 months and 52% at 12 months; baseline eGFR 38mL/min/m² . The adherence rate also improved to 84% versus 62% and the quality of life improved to 71/100 compared to 48/100. The episodes of AKI reduced from 32% to 14%, infections from 41% to 19%, hypertension from 36% to 22%, nephrotic-syndrome-relapse from 28% to 12%, and the hospitalisation rate from 1.8 to 0.9 per patient-year. The regression analysis revealed that the following factors were significant predictors of renal improvement: nursing intensity (β = 0.41, p < 0.01), early screening participation (β = 0.36, p < 0.01), tele-support frequency (β = 0.33, p < 0.05), and home-care engagement (β = 0.29, p < 0.05). The long-term renal health of pediatric patients can be enhanced by a multidisciplinary approach and effective nursing leadership, screening in the early stages, and structured home-based instruction.