SAT-306 Clinical Profile and outcome of Children who received Renal Replacement Therapy for Acute Kidney Injury in Tikur Anbessa Specialized Hospital; an ISN/ SRC trio experience.

Abstract

Acute kidney injury (AKI) requiring Renal Replacement Therapy (RRT) is associated with high mortality. The study assessed the impact of the introduction of RRT on outcomes of patients with AKI in Pediatric Nephrology unit in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. We provide acute Peritoneal Dialysis and acute intermittent Heamodialysis with support from the ISN SRC trio program for few selected cases due to lack of resources. A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring Intermittent Hemodialysis and Acute Peritoneal Dialysis (IHD/ APD) at a tertiary hospital in Addis Ababa, Ethiopia. Data was collected on patients who received RRT for AKI from July 2016 to October 2018. Patient demographics, commodities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. There were 35 children in this cohort; median age was 9 years (IQR 4 months – 15 years). Females comprised 54.3% of the cohort. Infectious diseases including Acute Gastroenteritis, Pneumonia, and severe Sepsis 7 (20%) and Acute Glomerulonephritis (AGN) 18 (54.28%) were the most frequent commodities. Oligo-anuria with pulmonary edema (91.4%) was the top indication for RRT. Overall mortality was 37.14%. Underlying severe sepsis and pulmonary edema in AGN patients were the most common causes of death. Twenty one (60%) of children had partial renal recovery on discharge. One child went home against medical advice. Eleven children received acute IHD in the adult Unit. Of the children who received APD, there was a 37.5% complication. Two children had catheter obstruction, 5 leaks from the insertion site and 2 children had peritonitis. We used a rigid catheters inserted at bedside with improvised fluids according to the ISPD guidelines using Ringer Lactate and Dextrose solutions. The availability of acute RRT in Pediatric Nephrology unit in TASH has resulted in improved patient survival. Early detection of AKI and prompt protocol based management are essential in reducing the morbidity and mortality related to AKI. We recommend vigorous resuscitation and management of sepsis to save lives. The ISN SRC program helped our unit in providing physicians' training and equipment to deliver a standardized health care service to children with AKI in our institution.