PAEDIATRIC ACUTE PERITONEAL DIALYSIS IN SOKOTO: REVIEW AND OUTCOME

Abstract

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.