The profile of adult nephrology patients admitted to the Renal Unit of the Universitas Tertiary Hospital in Bloemfontein, South Africa from 1997 to 2006.
BACKGROUND
This paper reports a retrospective audit of new patients referred to the Renal Unit at Universitas Academic Hospital in Bloemfontein, South Africa for the decade 1997-2006.


METHODS
All the files kept in the Renal Unit were reviewed for the main clinical presentation, a definitive pathological diagnosis (if obtained), age, race and gender of the patients. No consultations from other disciplines were included.


RESULTS
One thousand two hundred and sixteen patients were included in the study. The main clinical presentations were as follows: chronic renal failure (CRF), 461 (37.9%); nephrotic syndrome, 203 (16.7%); hypertension, 161 (13.2%); and abnormal urinary findings, 128 (10.5%). The nephrotic syndrome was the most common indication for renal biopsy, and histological investigation revealed focal segmental glomerulosclerosis in 46 (3.8%) patients, minimal change in 23 (1.9%), membranoproliferative disease in 36 (3.0%) and membranous glomerular disease (MN) in 28 (2.3%). In CRF, hypertension was suspected in 236/461 (51.2%) cases but was proven histologically in only 13 (2.8%) patients.


CONCLUSIONS
Socio-political factors impacting on access to healthcare most likely had an influence on the referral pattern of patients during this period. The largest group of patients were referred to our institution late in their disease with CRF, often requiring renal replacement therapy, and a definitive diagnosis was seldom possible at that stage. With the limited availability of dialysis facilities, the need for early detection and preventative measures with regard to renal disease in this community is evident.
van Rensburg
Barend Wilhelm Jansen
BW
Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa. gninbwvr.md@ufs.ac.za
van Staden
Anna Maria
AM
Rossouw
Gerrit Jacobus
GJ
Joubert
Georgina
G
D000328:Adult; D044383:Black People / Q000208:ethnology; D002908:Chronic Disease; D054869:Clinical Audit; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000150:complications; D007674:Kidney Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D006435:Renal Dialysis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D044465:White People / Q000208:ethnology