Acute peritoneal dialysis in children with acute kidney injury at the University of Abuja Teaching Hospital, Abuja, Nigeria: a report of 12 months experience in a developing country

Abstract

Background: Acute peritoneal dialysis (APD) is becoming a common modality of renal support in children with acute kidney injury (AKI) in developing countries. Objectives: To describe the details of APD among children with AKI at the University of Abuja Teaching Hospital, Abuja, Nigeria Methods: A retrospective review of children with AKI that had manual APD with an improvised nasogastric tubes from Jan- uary to December 2017 Results: Forty-three AKI cases were managed in the study period out of which 19 were treated with APD (dialysis access rate of 100%). Ten (52.6%) were males. Causes of AKI included sepsis in 9 (47.3%), hypovolaemia from diarrhoea in 4 (21.1%), acute glomerulonephritis in 3 (15.8%) and acute tubular necrosis from severe malaria fever in 3 (15.8%). Their ages ranged from 1 month to 72 months with a mean age of 30.9 months and a mean weight of 10.9 kilograms. Peri-catheter leakages (9, 47%), outflow obstruction (6, 31.6%), peritonitis (5, 26.3%), hyperglycaemia (4, 21.1%) and hypokalaemia (4, 21.1%) were the complications seen. Klebsiella species (4) and Staphylococcus aureus (1) were the bacteria isolated. Five of the 19 children died giving a mortality rate of 26.3%. Conclusion: APD remains a lifesaving, cheap and affordable mode of renal replacement therapy in a developing country like Nigeria. Fortunately, complications from APD are also manageable and they should not discourage its use. Keywords: Manual acute peritoneal dialysis; improvised acute peritoneal catheter; resource constrained setting.