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  • Title: An audit of a decade of acute peritoneal dialysis in children with acute kidney injury: A single-center experience.
    Author: Ezeh GO, Oniyangi O, Nwatah VE, Oyinwola OI, Ekaidem IB, Okonkwo FO, Aikhionbare HA.
    Journal: Niger J Clin Pract; 2022 May; 25(5):690-694. PubMed ID: 35593614.
    Abstract:
    BACKGROUND: Acute peritoneal dialysis (PD) is the modality of choice to manage children with acute kidney injury (AKI). However, its use remains underutilized, despite the unquestionable advantages. AIMS: This study, therefore, aimed to audit the complications, outcomes, and challenges encountered with PD as well as indications for PD and causes of AKI among under-5 children that had PD in a Nigerian tertiary hospital over a decade. . PATIENTS AND METHODS: : A retrospective study of children with AKI, aged 0 to 5 years, managed with PD. In all the children, a PD catheter was inserted at the bedside by surgeons. PD was performed manually. Data were presented in descriptive statistics and a P value <0.05 was considered significant. RESULTS: Twenty-nine (29) children had PD over a decade (January 2009 to December 2018). There were 12 males and 17 females aged 4-60 months (mean ± SD 18.8 ± 16.9). The PD yearly frequency was 2-7 times/year, mean of 2.9/year. The major identified indication for PD was difficulty of vascular access (86.2%) while the causes of AKI were sepsis 21 (43.8%); gastroenteritis 11 (22.9%); severe malaria 9 (18.8%); toxins/herbal medications 5 (10.4%); multiple congenital anomalies 2 (4.2%). Multiple causes of AKI occurred in some children. The major observed PD complications were catheter lockage 9 (37.5%); dialysate fluid retention 4 (16.7%); and peritonitis 4 (16.7%). The short-term outcome of the 29 children that had PD showed 20 (69%) discharged and 9 (31%) deaths over the period. The major challenge encountered was PD-related sepsis evidenced by the prevalence of peritonitis and catheter site infection. CONCLUSION: The predominant PD complications were catheter-related, mostly catheter blockage in a manually performed PD while the leading cause of AKI in our center was sepsis, affecting a large population of children requiring PD.
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