Background: Renal replacement therapy (RRT) in form of peritoneal dialysis (PD) is an important treatment
procedure in Paediatric Acute Kidney Injury (AKI) management. It is cost effective and materials are easily
sourced for in the developing countries. There is paucity of sub-Saharan Africa data on the use of PD in paediatric
AKI, hence this study.
Methods: This was a retrospective and descriptive study of cohort of children who were admitted into Emergency
Paediatrics Unit of Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, and had
PD done between July 1st, 2007 and July 31st, 2019. Age, gender, cause of AKI, indication for dialysis, type of
dialysis fluid and peritoneal access used, duration, complication and outcome were documented.
Results: A total number of 11 children who had acute PD due to AKI during the duration were studied with male
preponderance of 8 (72.7%) and majority (81.8%) belonging to lower social class (IV and V). Their ages ranged
between 5 months and 12 years with a mean age of 4.8±3 years. Acute glomerulonephritis (AGN) (n = 5), severe
acute diarrhoeal disease (n = 4) and obstructive nephropathy (n =2) were causes of AKI. Peritoneal dialysis was
performed manually using percutaneous commercial PD catheters (n=10) and adapted catheter (n=1). Duration
of PD ranged from 3 to 17 days (mean: 8.1±4.1 days). The main complications were peri-catheter leakage (n = 6),
and catheter obstruction (n = 3), exit wound (n=2) and acute bacterial peritonitis (n = 1). Of the 11 patients, 7
(63.6%) were discharged home alive and well, 3 (27.4%) died and 1(9.1%) left against medical advice.
Conclusion: With meticulous attention to aseptic procedure and use of improvised dialysis fluids and catheters
or semi-rigid PD catheters where available, PD is an affordable choice of RRT in management of paediatric AKI.
Complications are bound to occur and are better anticipated and planned for. |